Long-term follow up of en face optical coherence tomography of the inner retinal surface following internal limiting membrane peeling for idiopathic macular holes

• Published in: International ophthalmology Vol. 41; no. 3; pp. 1003 - 1010
• Main Authors: Goel, Neha, Shukla, Gaurav
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.03.2021; Springer Nature B.V
• Subjects: Acuity; Constraining; Eye; Eye (anatomy); Face; Medicine; Medicine & Public Health; Membranes; Ophthalmology; Optical Coherence Tomography; Original Paper; Peeling; Regression analysis; Retina; Tomography; Visual acuity; Pars plana vitrectomy; En face optical coherence tomography; Full thickness macular hole; Internal limiting membrane; Peeling; Inner retinal dimpling; Dissociated optic nerve fibre layer; Muller cells
• ISSN: 0165-5701; 1573-2630; 1573-2630
• DOI: 10.1007/s10792-020-01657-1

Purpose To evaluate sequential changes in the inner retinal surface using en face spectral domain optical coherence tomography (SD-OCT) following internal limiting membrane (ILM) peeling for idiopathic full thickness macular holes. Methods Retrospective, interventional study on 45 eyes of 42 patients with type 1 macular hole closure after a single procedure and a minimum post-operative follow up of 6 months. Best corrected visual acuity (BCVA), fundus photographs, B scan and en face SD-OCT scans were analysed pre-operatively, at 2, 6, 12 months post-operatively and then yearly. The presence or absence of concentric macular dark spots (CMDS) on the ILM slab of en face SD-OCT, their distribution pattern and course in terms of number and size of the dark spots was qualitatively assessed at each follow up. Results CMDS was identified in a total of 26 eyes (57.78%). Of these, it was detected in 21 eyes at 2 months and the remaining by 6 months. At the time of first detection, the distribution was classified as type 1 in 9 eyes (35%), type 2 in 7 eyes (27%) and type 3 in 10 eyes (38%). There was apparent increase in the number and size of the CMDS in 16 eyes (62%) no later than 12 months follow up, while 10 eyes (38%) remained stable. There was no decrease or resolution noted in any patient. The mean post-operative follow up was 19.4 months (range 6–69 months). Conclusion Inner retinal defects in the form of CMDS can be picked up on en face SD-OCT between 2–6 months post-operatively. They remain stable or become more prominent upto 12 months follow up, but do not regress once present. En face SD-OCT is recommended in all cases where ILM is peeled to assess CMDS.