Long-term follow up of en face optical coherence tomography of the inner retinal surface following internal limiting mem
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ORIGINAL PAPER
Long-term follow up of en face optical coherence tomography of the inner retinal surface following internal limiting membrane peeling for idiopathic macular holes Neha Goel
. Gaurav Shukla
Received: 21 June 2020 / Accepted: 9 November 2020 Ó Springer Nature B.V. 2020
Abstract 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 SDOCT 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.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01657-1) contains supplementary material, which is available to authorized users.
Keywords Dissociated optic nerve fibre layer Inner retinal dimpling En face optical coherence tomography Internal limiting membrane Muller cells Pars plana vitrectomy Peeling Full thickness macular hole
N. Goel (&) G. Shukla ICARE Eye Hospital and Postgraduate Institute, NOIDA, UP, India e-mail: [email protected] Present Address: N. Goel Eye7 Chaudhary Eye Centre, Daryaganj, New Delhi 110002, India
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Int Ophthalmol
Introduction Tadayoni et al. in 2001 first described a peculiar dissociated optic nerve fibre layer (DONFL) appearance within the posterior pole, consisting of numerous dark arcuate retinal striae in the direction of optic nerve fibres mimicking a retinal nerve fibre layer (RNFL) defect. This was seen using blue filtered fundus photographs (wavelength 490 nm) following epiretinal membrane (ERM) removal [1]
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