The changes of macular microstructure in large idiopathic macular hole after vitrectomy combined with internal limiting membrane transplantation or internal limiting membrane peeling_Chinese Journal of Ocular Fundus Diseases

Authors：

XiRuijie ,  HaoYuhua , HanYou , TianXiaoyu , ShiJunfang , WeiYuhua

Department of Ophthalmology, The Second Hospital of Hebei Medical Univercity, Shijiazhuang 050000, China;

Corresponding author：

HaoYuhua, Email: yuhuasjz@sina.com

Keywords：

Retinal perforations/surgery; Vitreoretinal surgery; Macula lutea/physiopathology

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.003

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Objective To observe the different changes of macular microstructure in patients with large idiopathic macular hole (IMH) treated with vitrectomy combined with internal limiting membrane (ILM) transplantation or not. Methods Forty eyes in 40 consecutive patients with giant IMH (≥500 μm) were included in the study. Twenty eyes received vitrectomy with ILM transplantation (ILM transplantation group) and others with ILM peel off (ILM removal group). During the operation, a proper size of the ILM was removed and filled in the bottom of the macular hole. The age, duration of disease and the ocular laterality of the two groups of patients were not statistically significant (P>0.05). Minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (SD-OCT) scan were examined. There was no statistically significant difference in logMAR BCVA, average defect diameter of photoreceptor ellipsoid (IS/OS) and average defect diameter of external limiting membrane (ELM) between two groups (t=0.128, 1.452, 1.321; P>0.05). The logMAR BCVA and SD-OCT were examined on 1, 3, 6, 12 months postoperatively. Results On 1 month after the surgery, there was no statistically significant difference in logMAR BCVA, average defect diameter of IS/OS and average defect diameter of ELM between two groups (t=1.226, 1.435, 1.018; P>0.05). On 3, 6, 12 months after the surgery, compared with ILM removal group, the logMAR BCVA (t=2.059, 2.871, 2.415) increased and the average defect diameter of IS/OS (t=2.070, 2.110, 2.121) and ELM (t=2.034, 3.647, 3.556) significantly reduced in ILM transplantation group (P<0.05). On 1 month after the surgery, there was statistically significant difference in CRT between two groups (t=2.113, P<0.05). On 3, 6, 12 months after the surgery, there was no statistically significant difference in CRT between two groups (t=0.428, 0.847, 0.849; P>0.05). Conclusion Compared with vitrectomy combined with ILM peeling surgery, the diameter of IS/OS and ELM defect were significantly decreased after vitrectomy combined with ILM transplantation in the patients with large IMH.

Citation： XiRuijie, HaoYuhua, HanYou, TianXiaoyu, ShiJunfang, WeiYuhua. The changes of macular microstructure in large idiopathic macular hole after vitrectomy combined with internal limiting membrane transplantation or internal limiting membrane peeling. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 468-472. doi: 10.3760/cma.j.issn.1005-1015.2016.05.003 Copy

1.	Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes:results of a pilotstudy[J]. Arch Ophthalmol,1991,109(5):654-659.
2.	Haritoglou C, Gass CA, Schaumberger M, et al. A long-term follow-up after macular hole surgery with internal limiting membrane peeling[J]. Am J Ophthalmol, 2002, 134(5):661-666.
3.	Gass JD. Idiopathic senile macular hole:its early stages and pathogenesis[J]. Arch Ophthalmol,1988,106(5):629-639.
4.	Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6):752-759.
5.	Ando F, Sasano K, Ohba N, et al. Anatomic and visual outcomes after indocyanine green-assisted peeling of the retinal internal limiting membrane in idiopathic macular hole surgery[J].Am J Ophthalmol, 2004,137(4):609-614.
6.	Beutel J, Dahmen G, Ziegler A, et al. Internal limiting membrane peeling with indocyanine green or trypan blue in macular hole surgery:a randomized trial[J]. Arch Ophthalmol, 2007, 125(3):326-332.
7.	Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
8.	Alpatov S, Shchuko A, Malyshev V. A new method of treating macular holes[J]. Eur J Ophthalmol, 2007, 17(2):246-252.
9.	Villate N, Lee JE, Venkatraman A, et al. Photoreceptor layer features in eyes with closed macular holes:optical coherence tomography findings and correlation with visual outcomes[J]. Am J Ophthalmol, 2005, 139(2):280-289.
10.	吴鹏, 黄旭东, 孙先勇, 等. 内界膜剥除及其联合内界膜移植治疗特发性黄斑裂孔的疗效对比观察[J]. 中华眼底病杂志, 2014, 30(3):253-256. DOI:10.3760/cma.j.issn.1005-1015.2014.03.007. Wu P, Huang XD, Sun XY, et al. Efficacy of internal limiting membrane peeling and transplantation for the treatment of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2014, 30(3):253-256.DOI:10.3760/cma.j.issn.1005-1015.2014.03.007.
11.	Michalewska Z, Michalewski J, Cisiecki S, et al. Correlation between foveal tructure and visual outcome following macular hole surgery:a spectral optical coherence tomography study[J]. Graefe´s Arch Clin Exp Ophthalmol, 2008, 246(6):823-830. DOI:10.1007/s00417-007-0764-5.
12.	张钊填, 魏雁涛, 黄雄高, 等. 影响特发性黄斑裂孔微创玻璃体切割手术后视力预后的相关因素研究[J]. 中华眼底病杂志, 2013, 29(2):126-130. DOI:10.3760/cma.j.issn.1005-1015.2013.02.003. Zhang ZT, Wei YT, Huang XG, et al. Correlation of postoperative vision acuity and optical coherence tomography characteristics of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2013, 29(2):126-130. DOI:10.3760/cma.j.issn.1005-1015.2013.02.003.
13.	Oh J, Smiddy WE, Flynn HW Jr, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery[J]. Invest Ophthalmol Vis Sci, 2010,51(3):1651-1658. DOI:10.1167/iovs.09-4420.
14.	De Novelli FJ, Preti RC, Ribeiro Monteiro ML,et al. Autologous internal limiting membrane fragment transplantation for large, chronic,and refractory macular holes[J]. Ophthalmic Res, 2015, 55(1):45-52. DOI:10.1159/000440767.

1. Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes:results of a pilotstudy[J]. Arch Ophthalmol,1991,109(5):654-659.
2. Haritoglou C, Gass CA, Schaumberger M, et al. A long-term follow-up after macular hole surgery with internal limiting membrane peeling[J]. Am J Ophthalmol, 2002, 134(5):661-666.
3. Gass JD. Idiopathic senile macular hole:its early stages and pathogenesis[J]. Arch Ophthalmol,1988,106(5):629-639.
4. Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6):752-759.
5. Ando F, Sasano K, Ohba N, et al. Anatomic and visual outcomes after indocyanine green-assisted peeling of the retinal internal limiting membrane in idiopathic macular hole surgery[J].Am J Ophthalmol, 2004,137(4):609-614.
6. Beutel J, Dahmen G, Ziegler A, et al. Internal limiting membrane peeling with indocyanine green or trypan blue in macular hole surgery:a randomized trial[J]. Arch Ophthalmol, 2007, 125(3):326-332.
7. Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
8. Alpatov S, Shchuko A, Malyshev V. A new method of treating macular holes[J]. Eur J Ophthalmol, 2007, 17(2):246-252.
9. Villate N, Lee JE, Venkatraman A, et al. Photoreceptor layer features in eyes with closed macular holes:optical coherence tomography findings and correlation with visual outcomes[J]. Am J Ophthalmol, 2005, 139(2):280-289.
10. 吴鹏, 黄旭东, 孙先勇, 等. 内界膜剥除及其联合内界膜移植治疗特发性黄斑裂孔的疗效对比观察[J]. 中华眼底病杂志, 2014, 30(3):253-256. DOI:10.3760/cma.j.issn.1005-1015.2014.03.007. Wu P, Huang XD, Sun XY, et al. Efficacy of internal limiting membrane peeling and transplantation for the treatment of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2014, 30(3):253-256.DOI:10.3760/cma.j.issn.1005-1015.2014.03.007.
11. Michalewska Z, Michalewski J, Cisiecki S, et al. Correlation between foveal tructure and visual outcome following macular hole surgery:a spectral optical coherence tomography study[J]. Graefe´s Arch Clin Exp Ophthalmol, 2008, 246(6):823-830. DOI:10.1007/s00417-007-0764-5.
12. 张钊填, 魏雁涛, 黄雄高, 等. 影响特发性黄斑裂孔微创玻璃体切割手术后视力预后的相关因素研究[J]. 中华眼底病杂志, 2013, 29(2):126-130. DOI:10.3760/cma.j.issn.1005-1015.2013.02.003. Zhang ZT, Wei YT, Huang XG, et al. Correlation of postoperative vision acuity and optical coherence tomography characteristics of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2013, 29(2):126-130. DOI:10.3760/cma.j.issn.1005-1015.2013.02.003.
13. Oh J, Smiddy WE, Flynn HW Jr, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery[J]. Invest Ophthalmol Vis Sci, 2010,51(3):1651-1658. DOI:10.1167/iovs.09-4420.
14. De Novelli FJ, Preti RC, Ribeiro Monteiro ML,et al. Autologous internal limiting membrane fragment transplantation for large, chronic,and refractory macular holes[J]. Ophthalmic Res, 2015, 55(1):45-52. DOI:10.1159/000440767.

Chinese Journal of Ocular Fundus Diseases

The changes of macular microstructure in large idiopathic macular hole after vitrectomy combined with internal limiting membrane transplantation or internal limiting membrane peeling

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