Abstract
To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.
Highlights
To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after fullthickness macular hole (FTMH) surgery
We identified that the inner retinal layer (IRL) tends to become thinner after FTMH surgery but still remains thicker than that of the fellow eye at 12 months after surgery
Besides recovery of the EZ, baseline bestcorrected visual acuity (BCVA), follow-up duration after surgery, minimum linear diameter (MLD), IRL thickness, and SFT were significant factors affecting the change in BCVA after surgery
Summary
To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after fullthickness macular hole (FTMH) surgery. The inner retinal layer (IRL) would be one of the important factors associated with the visual outcomes after FTMH surgery. Bottoni et al.[10] reported recovery of the external limiting membrane (ELM) and ellipsoid zone (EZ) is important for the improvement of visual acuity after FTMH surgery. They insisted that the ELM is the first structure to recover and gradual recovery of the EZ occurs in the presence of an intact outer nuclear layer (ONL). We analyzed the process of the changes in each retinal layer and the foveal recovery of the ELM, ONL, and EZ after the anatomic success of FTMH surgery. We tried to identify the factors affecting changes in visual acuity and those associated with EZ recovery
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