TY - JOUR
T1 - RESTORATION PROCESS OF THE OUTER RETINAL LAYERS AFTER SURGICAL MACULAR HOLE CLOSURE
AU - Iwasaki, Masanori
AU - Ando, Ryo
AU - Aoki, Shuichiro
AU - Miyamoto, Hirotomo
N1 - Publisher Copyright:
Copyright © by Ophthalmic Communications Society, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Purpose: To investigate the interrelationship among the outer retinal layers after macular hole surgery and elucidate the restoration process. Methods: This retrospective observational study included 50 eyes of 47 consecutive patients with closed macular holes in the first vitrectomy. Optical coherence tomography was obtained before surgery; at 1, 3, and 6 months postsurgery; and at the last visit. The complete continuous layer rate and mean defect length were evaluated for the outer nuclear layer (ONL), external limiting membrane (ELM), and ellipsoid zone (EZ). Results: At all postoperative visits, the complete continuous layer rate was in the descending order of ELM, ONL, and EZ and the mean defect length was in the ascending order of ELM, ONL, and EZ. External limiting membrane was necessary for ONL restoration. External limiting membrane and ONL were necessary for EZ restoration. Hyperreflective protrusions were observed from the area lacking ELM into the subretinal space after surgery. Ellipsoid zone was not formed in coexistence with the hyperreflective protrusions. Intermediate reflective protrusions appeared under the ONL plus ELM after surgery and were eventually replaced by EZ. Conclusion: Restoration of the outer retinal layers after surgical macular hole closure occurs in the order of ELM, ONL, and EZ.
AB - Purpose: To investigate the interrelationship among the outer retinal layers after macular hole surgery and elucidate the restoration process. Methods: This retrospective observational study included 50 eyes of 47 consecutive patients with closed macular holes in the first vitrectomy. Optical coherence tomography was obtained before surgery; at 1, 3, and 6 months postsurgery; and at the last visit. The complete continuous layer rate and mean defect length were evaluated for the outer nuclear layer (ONL), external limiting membrane (ELM), and ellipsoid zone (EZ). Results: At all postoperative visits, the complete continuous layer rate was in the descending order of ELM, ONL, and EZ and the mean defect length was in the ascending order of ELM, ONL, and EZ. External limiting membrane was necessary for ONL restoration. External limiting membrane and ONL were necessary for EZ restoration. Hyperreflective protrusions were observed from the area lacking ELM into the subretinal space after surgery. Ellipsoid zone was not formed in coexistence with the hyperreflective protrusions. Intermediate reflective protrusions appeared under the ONL plus ELM after surgery and were eventually replaced by EZ. Conclusion: Restoration of the outer retinal layers after surgical macular hole closure occurs in the order of ELM, ONL, and EZ.
KW - Ellipsoid zone
KW - External limiting membrane
KW - Inverted internal limiting membrane flap technique
KW - Macular hole
KW - Müller cell process
KW - Optical coherence tomography
KW - Outer nuclear layer
KW - Outer retinal layer restoration process
KW - Photoreceptor inner/outer segment regeneration
KW - Vitrectomy
UR - http://www.scopus.com/inward/record.url?scp=85123814408&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000003323
DO - 10.1097/IAE.0000000000003323
M3 - Article
C2 - 34723901
AN - SCOPUS:85123814408
SN - 0275-004X
VL - 42
SP - 313
EP - 320
JO - Retina
JF - Retina
IS - 2
ER -