J Korean Ophthalmol Soc.  2008 Feb;49(2):253-260. 10.3341/jkos.2008.49.2.253.

Analysis of the Maular Change in Optical Coherent Tomography after Internal Limiting Membrane Peeling

• Kim HJ
• Lee JH

• KMID: 2127116
• DOI: http://doi.org/10.3341/jkos.2008.49.2.253

Abstract

PURPOSE: To analyse the postoperative anatomical changes of maculae using optical coherent tomography after internal limiting membrane peeling during vitrectomy.
METHODS
A retrospective review of 22 patients (22 eyes) who underwent vitrectomy with internal limiting membrane peeling was performed. Age, sex, fundus findings, BCVA, operation methods, complications, and postoperative OCT findings were recorded.
RESULTS
Of 22 eyes, 12 eyes had epiretinal membranes, 5 eyes had macular holes, and 5 eyes had diffuse diabetic macular edemas. Eighteen of 22 eyes underwent internal limiting membrane peeling using ICG, with 1 eye treated with triamcinolone and 3 eyes treated with nothing. The postoperative improvement of BCVA was statistically significant in epiretinal membrane and diffuse macular edema patients (p<0.05), but insignificant in macular hole patients (p>0.05). Postoperative OCT findings of 17 eyes showed that they had returned to normal shape and thickness. However, among the 18 eyes that underwent ICG dye-assisted ILM, 3 eyes showed irregular macular thinning and 1 eye showed macular cystic changes. One eye treated with triamcinolone presented with a recurrent cytoid macular edema. No postoperative complications or recurrences were reported by epiretinal membrane patients.
CONCLUSIONS
Changes to macular shape did not significantly affect the final BCVA after internal limiting membrane peeling, but they can cause changes to the microstructure of maculae. Therefore, caution during surgery and close follow-up are necessary.

Keyword

Internal limiting membrane peeling; Optical coherent tomography

MeSH Terms

Epiretinal Membrane
Eye
Follow-Up Studies
Humans
Macular Edema
Membranes
Postoperative Complications
Recurrence
Retinal Perforations
Retrospective Studies
Triamcinolone
Vitrectomy
Triamcinolone

Figure

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  Figure 1. (A) preoperative fundus photography; (B) preoperative fluorescien angiography; (C) peeled ILM, electromicroscopic finding X 150,000; (D) fundus photography at 1 year after operation; (E) OCT finding shows irregular surface and thinning of the macular area.

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  Figure 2. (A) preoperative fundus photography; (B) preoperative OCT finding; (C) peeled ILM, electromicroscopic finding X 20,000; (D) OCT finding at 1 day after operation; (E) fundus photograph at 6 month after operation; (F) OCT finding at 6 month after operation.

Reference

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