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INTERNAL LIMITING MEMBRANE PEELING–DEPENDENT RETINAL STRUCTURAL CHANGES AFTER VITRECTOMY IN RHEGMATOGENOUS RETINAL DETACHMENT

Hisatomi, Toshio MD, PhD*,†; Tachibana, Takashi MD*; Notomi, Shoji MD, PhD*,†; Koyanagi, Yoshito MD*,†; Murakami, Yusuke MD, PhD*; Takeda, Atsunobu MD, PhD*,†; Ikeda, Yasuhiro MD, PhD*; Yoshida, Shigeo MD, PhD*; Enaida, Hiroshi MD, PhD; Murata, Toshinori MD, PhD§; Sakamoto, Taiji MD, PhD; Sonoda, Koh-Hei MD, PhD*; Ishibashi, Tatsuro MD, PhD*

doi: 10.1097/IAE.0000000000001558
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Purpose: To examine retinal changes after vitrectomy with internal limiting membrane (ILM) peeling, we used 3-dimensional optical coherence tomography (3D-OCT) in rhegmatogenous retinal detachment cases.

Methods: The 68 eyes from 67 patients with rhegmatogenous retinal detachment were studied, including 35 detached macula cases (51%) and 33 attached macula cases. Internal limiting membrane peeling was performed with fine forceps after brilliant blue G staining. The 3D-OCT images were obtained with volume-rendering technologies from cross-sectional OCT images.

Results: The 3D-OCT detected 45 eyes (66%) with ILM peeling-dependent retinal changes, including dissociated optic nerve fiber layer appearance, dimple sign, temporal macular thinning, ILM peeling area thinning, or forceps-related retinal thinning. The ILM peeled area was detectable in only 9 eyes with 3D-OCT, whereas it was undetectable in other 59 eyes. The dissociated optic nerve fiber layer appearance was detected in 8 of the total cases (12%), and dimple signs were observed in 14 cases (21%). Forceps-related thinning was also noted in eight cases (24%) of attached macula cases and in four cases (11%) of detached macula cases. No postoperative macular pucker was noted in the observational period.

Conclusion: The 3D-OCT clearly revealed spatial and time-dependent retinal changes after ILM peeling. The changes occurred in 2 months and remained thereafter.

To examine retinal changes after vitrectomy with internal limiting membrane peeling, the authors used 3-dimensional optical coherence tomography in 68 eyes with rhegmatogenous retinal detachment. The 3-dimensional optical coherence tomography detected 45 eyes (66%) with internal limiting membrane peeling–dependent retinal changes, including dissociated optic nerve fiber layer appearance, dimple sign, temporal macular thinning, peeling area thinning, or forceps-related thinning. These changes developed in 2 months and remained thereafter.

*Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;

Clinical Research Institute, Kyushu Medical Centre, Fukuoka, Japan;

Department of Ophthalmology, Saga University School of Medicine, Saga, Japan;

§Department of Ophthalmology, Shinshu University School of Medicine, Nagano, Japan; and

Department of Ophthalmology, Kagoshima University School of Medicine, Kagoshima, Japan.

Reprint requests: Toshio Hisatomi, MD, PhD, Department of Ophthalmology, Graduate school of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; e-mail: hisatomi@med.kyushu-u.ac.jp

None of the authors has any financial/conflicting interests to disclose.

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© 2018 by Ophthalmic Communications Society, Inc.