Abstract
Objective
To evaluate the long-term structural and microvascular retinal effects of internal
limiting membrane peeling for full-thickness macular hole (FTMH) using en face adaptive
optics optical coherence tomography (AO-OCT), conventional OCT, and OCT angiography
(OCTA).
Design
Interventional case series.
Participants
Patients with FTMH treated with vitrectomy, internal limiting membrane peeling, and
gas tamponade.
Methods
Eleven eyes with FTMH that had at least 12 months of postoperative follow-up were
enrolled in the study. En face AO-OCT was used to image the superficial retina in
the peeled and nonpeeled areas. En face structural OCT was performed to image the
inner retinal dimples (IRDs), macular thickness, and retinal nerve fibre layer (RNFL).
En face OCTA was used to examine the integrity of the peripapillary nerve fibre layer
(NFL) plexus.
Results
AO-OCT showed RFNL wrapping around the IRDs, and no obvious peripapillary NFL plexus
dropout was seen with OCTA. Scattered hyper-reflective dots were observed on the surface
of the peeled retina in all patients imaged with AO-OCT. No significant differences
were found in IRD number (91.5 ± 24.4 versus 77.2 ± 14.7; P = 2.07), IRD proportionate area (8.36 ± 3.34 versus 7.53 ± 2.60; P = 0.159), or macular thickness between the 6- and 12-month (or greater) postoperative
visits.
Conclusion
IRDs do not to progress beyond 6 months postoperatively, and no obvious damage to
RFNL and peripapillary NFL plexus was detected. Hyper-reflective dots on the surface
of the retina suggestive of possible Müller cell reactive gliosis were identified
with AO-OCT.
Objectif
Évaluer les effets structurels et microvasculaires rétiniens à long terme à la suite
du pelage de la membrane limitante interne réalisée en raison d'un trou maculaire
de pleine épaisseur (TMPE) grâce à 3 techniques d'imagerie en face : le couplage de
l'optique adaptative avec la tomographie par cohérence optique (OCT) (AO-OCT), l'OCT
classique et l'angiographie-tomographie par cohérence optique (OCTA).
Nature
Étude d'intervention d'une série de cas.
Participants
Patients dont le TMPE a été traité par vitrectomie, pelage de la membrane limitante
interne et tamponnade au gaz.
Méthodes
Ont été inclus 11 yeux présentant un TMPE dont le suivi postopératoire atteignait
au moins 12 mois. L'AO-OCT en face a servi à imager la rétine superficielle, tant
dans les zones qui ont subi le pelage que dans les autres. Une OCT structurale en
face a été réalisée pour obtenir des images des fossettes rétiniennes internes (IRD),
de l’épaisseur maculaire et de la couche de fibres nerveuses rétiniennes (RNFL). On
a eu recours à l'OCTA en face pour examiner l'intégrité du plexus de la couche de
fibres nerveuses péripapillaires.
Résultats
L'AO-OCT a mis au jour un enroulement de la RNFL autour des IRD, tandis que l'OCTA
n'a fait ressortir aucune diminution évidente du plexus de la couche de fibres nerveuses
péripapillaires. Des points hyperréflectifs dispersés ont été observés sur la surface
de la rétine soumise au pelage chez tous les patients qui ont fait l'objet d'une AO-OCT.
Aucune différence significative n'a été notée quant au nombre d'IRD (91,5 ± 24,4 vs
77,2 ± 14,7; p = 2,07), à la superficie proportionnelle des IRD (8,36 ± 3,34 vs 7,53 ± 2,60; p = 0,159) ni à l’épaisseur maculaire entre le 6e et le 12e mois postopératoire (ou au-delà).
Conclusion
Les IRD n'ont plus progressé au-delà du 6e mois après l'intervention, et aucune lésion évidente de la RNFL ni du plexus de la
couche de fibres nerveuses péripapillaires n'a été détectée. Des points hyperréflectifs
à la surface de la rétine pouvant évoquer une éventuelle gliose réactive des cellules
de Müller sont apparus à l'AO-OCT.
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Article info
Publication history
Published online: October 20, 2021
Accepted:
September 19,
2021
Received in revised form:
September 8,
2021
Received:
May 13,
2021
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
