Appearance of the Internal Limiting Membrane and Dissociated Optic Nerve Fiber Layer in Macular Hole Patients

1. Tetsuo Ogino
2. Hiroko Imaizumi
3. Utako Okushiba
4. Hirotomo Miyamoto
5. Takamasa Kinoshita

Sapporo City General Hospital, Sapporo, Japan

Purpose: To visualize the internal limiting membrane (ILM) and dissociated optic nerve fiber layer (DONFL) in post-vitrectomy macular hole patients using three-dimensional optical coherence tomography (3D-OCT).

Methods: Seventeen post-vitrectomy macular hole patients (9 male and 8 female) were examined. 3D-OCT formed over 512 pixels covering of 6×6-mm regions of the macula. Only triamcinolone was used for ILM peeling and indocyanine green or bririant blue wasn't used. Color fundus photo and 3D-OCT were examined at the time of pre-vitrectomy and 1, 2, 3, 4, 5, and 6 weeks and 3, 6, 9, and 12 months after vitrectomy.

Results: 100% of macular holes closed after the first surgery. The demarcation line of ILM peeling and DONFL were observed in the all post-vitrectomy macular hole patients using 3D-OCT. The demarcation line of ILM peeling was demonstrated clearly at 1.9±0.5 (mean±SD) weeks and became unclear 4.1±1.1 weeks after vitrectomy. Conversely, the DONFL was observed clearly 2.1±0.7 weeks after vitrectomy and remained one year later.

Conclusion: The 3D-OCT technique was found to be useful in visualizing the ILM and DONFL sequentially.