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Updated: Apr 22, 2026

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Evaluating dissociated optic nerve fiber layer appearance using en face layer imaging produced by optical coherence

Sentaro Kusuhara1, Wataru Matsumiya, Hisaori Imai

  • 1Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Ophthalmologica. Journal International D'Ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde
|October 18, 2014
PubMed
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Macular hole surgery significantly increases the risk of a dissociated optic nerve fiber layer (DONFL) appearance after pars plana vitrectomy (PPV). This finding highlights specific patient groups susceptible to DONFL post-PPV.

Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Optical Coherence Tomography

Background:

  • Pars plana vitrectomy (PPV) is a common surgical procedure for various retinal conditions.
  • Internal limiting membrane removal is often performed during PPV.
  • Dissociated optic nerve fiber layer (DONFL) appearance is a potential postoperative complication.

Purpose of the Study:

  • To determine the incidence of DONFL appearance after PPV.
  • To identify risk factors associated with DONFL development post-PPV.

Main Methods:

  • Retrospective review of 189 eyes undergoing PPV with internal limiting membrane removal.
  • Assessment of DONFL presence using spectral-domain optical coherence tomography (SD-OCT) en face imaging.

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Main Results:

  • DONFL was observed in 24.9% of eyes.
  • Macular hole (MH) surgery showed a significantly higher incidence (76.5%) compared to other indications (4.9%).
  • MH as a surgical indication was the strongest risk factor for DONFL (OR 63.7).

Conclusions:

  • Postoperative SD-OCT en face imaging is crucial for identifying DONFL.
  • Eyes undergoing PPV for MH are highly susceptible to developing DONFL.