"Dissociated optic nerve fiber layer appearance" after internal limiting membrane removal is inner retinal dimpling

Area of Science:

• Ophthalmology
• Retinal Imaging
• Surgical Outcomes

Background:

• Vitrectomy is a common surgical procedure for retinal conditions.
• Internal limiting membrane (ILM) peeling is frequently performed during vitrectomy.
• Dissociated optic nerve fiber layer appearance is a potential complication.

Purpose of the Study:

• To investigate inner retinal abnormalities after vitrectomy using volume-rendered spectral-domain optical coherence tomography (SD-OCT).
• To examine the relationship between ILM peeling and the development of "dissociated optic nerve fiber layer appearance."

Main Methods:

• Evaluated patients who underwent vitrectomy for macular hole or epiretinal membrane.
• Acquired SD-OCT B-scan images with eye tracking.
• Registered and rendered images in 3D to assess inner retinal abnormalities.
• Correlated findings with fundus photographs and SD-OCT B-scans.

Main Results:

• 13 out of 25 eyes (52%) exhibited inner retinal dimples following ILM peeling.
• These dimples followed the nerve fiber layer path in the macula.
• Dimples correlated with ganglion cell layer thinning and reduced nerve fiber layer reflectivity on SD-OCT.
• Dimples were exclusively observed in eyes with ILM peeling.

Conclusions:

• Inner retinal dimples are a frequent consequence of ILM peeling during vitrectomy.
• These dimples result from trauma and healing, not optic nerve fiber dissociation.
• Long-term risks and benefits of routine ILM peeling require further investigation.