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Similarity With Alport Syndrome

Fukukita, Hiroshi, MD; Ito, Yasuki, MD; Iwase, Takeshi, MD; Kaneko, Hiroki, MD; Yasuda, Shunsuke, MD; Kataoka, Keiko, MD; Terasaki, Hiroko, MD

doi: 10.1097/IAE.0000000000002310
Original Study: PDF Only

Purpose: The internal limiting membrane (ILM), the innermost basement membrane of the retina, is peeled occasionally during vitreous surgery. This study aimed to investigate the effect of ILM loss on the retina.

Methods: We used optical coherence tomography to retrospectively evaluate retinal changes in 26 eyes (11 ILM-peeled and 15 ILM-unpeeled eyes) of 26 patients after vitrectomy for retinal detachment. In addition, we studied six eyes of three patients with Alport syndrome, in which ILM is genetically impaired.

Results: We observed significant inner retinal displacement of the foveal pit toward the optic disk with inner retinal thickening in the nasal area (fellow, 191.9 ± 24.3 μm vs. affected, 210.3 ± 31.4 μm; P = 0.048), inner retinal thinning in the temporal area (fellow, 174.3 ± 18.3 μm vs. affected, 142.2 ± 23.6 μm; P < 0.001), foveal thickening (ILM-unpeeled, 217.0 ± 39.4 μm vs. ILM-peeled, 302.0 ± 86.2 μm; P = 0.006), inner retinal dimples predominantly in the temporal area, and deviation between the foveal pit and foveal bulge. Eyes with Alport syndrome exhibited similar findings.

Conclusion: Internal limiting membrane loss seems to cause characteristic inner retinal changes of the macula in both congenital and acquired conditions.

After vitrectomy with internal limiting membrane peeling for rhegmatogenous retinal detachment, the inner retinal foveal region displaces toward the optic disk in association with nasal inner retinal thickening and temporal inner retinal thinning. The similarity with Alport syndrome suggests that these changes are caused by the loss of the internal limiting membrane.

Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.

Reprint requests: Yasuki Ito, MD, Department of Ophthalmology, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Japan; e-mail:

Grant-in Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (16K11265 [Y.I.] and 15H04994 [H.T.]).

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

© 2019 by Ophthalmic Communications Society, Inc.