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En-face spectral-domain OCT (SD-OCT) characteristics of the inner retinal surface after internal limiting membrane (ILM) peeling for idiopathic macular hole

Session Details

Session Title: Imaging I

Session Date/Time: Friday 18/09/2015 | 08:00-09:30

Paper Time: 08:08

Venue: Athena

First Author: : N.Goel INDIA

Co Author(s): :                  

Abstract Details

PURPOSE:To describe the characteristics of the inner retinal surface using en-face spectral-domain OCT (SD-OCT) after internal limiting membrane (ILM) peeling in idiopathic full-thickness macular holes (FTMH).


This study was conducted at a tertiary eye care center.


Retrospective, interventional case series. 32 eyes of 30 patients with idiopathic FTMH who underwent standard three-port 23G pars plana vitrectomy with ILM peeling and C3F8 gas injection were analyzed using en-face SD-OCT before and after surgery. Preoperative and postoperative best-corrected Snellen visual acuity (BCVA), fundus photographs and B-scan SD-OCT images were also reviewed. Patients were followed up for a minimum of 6 months.


There were 34 eyes of 32 patients with a mean age of 65.9 years, 14 of whom were women. Anatomic success rate was 100% after a single surgical procedure. The en-face feature of multiple dark dots along the course of retinal nerve fibers in the area of the ILM peeling termed ‘‘concentric macular dark spots’’ (CMDS), was observed in 14 eyes at 2 months (41.2%) after surgery and 18 eyes at 6 months post operatively (52.9%). The foveal-centered pattern was observed most commonly. This feature was not visible on fundus photographs. In these eyes, the B-scan OCT images indicated dimples in the retinal nerve fiber layer (RNFL) corresponding to each stria. In the eyes without the CDMS appearance, OCT images showed no distinct dimples. The postoperative BCVA and its improvements were not significantly different between eyes with and without CDMS. Mean follow-up was 10.8 months (range, 6–24 months).


Inner retinal defects as picked up on en-face SD-OCT frequently occurred after idiopathic MH surgery when ILM was peeled. This is a helpful, noninvasive technique to assess complete ILM removal in FTMH surgery if CMDS appearance on the retinal surface is reported. This feature did not preclude good visual recovery.

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