Decrease of the foveal avascular zone area after internal limiting membrane peeling: single case study

Area of Science:

• Ophthalmology
• Retinal Surgery
• Optical Coherence Tomography Angiography

Background:

• Epiretinal membranes can affect retinal structure and function.
• Vitrectomy with internal limiting membrane (ILM) peeling is a surgical technique used to treat various retinal conditions.
• The foveal avascular zone (FAZ) is a key indicator of retinal health.

Observation:

• A 58-year-old woman with a thin epiretinal membrane underwent phacovitrectomy with ILM peeling.
• Optical coherence tomography angiography (OCTA) was used to assess changes in the superficial and deep inner retinal vascular plexuses.
• Measurements of FAZ area and parafoveal retinal thickness were taken preoperatively and at multiple time points postoperatively.

Findings:

• The foveal avascular zone (FAZ) area significantly decreased in both superficial and deep retinal plexuses after surgery.
• The reduction in FAZ area followed a hyperbolic curve in the superficial plexus.
• A notable increase in the thickness of the retinal nerve fiber layer, ganglion cell-inner plexiform layer, and inner nuclear layer was observed post-surgery.

Implications:

• The observed decrease in FAZ suggests a potential structural change in the macula following ILM peeling.
• The increase in parafoveal retinal thickness may indicate a centripetal movement of retinal layers, possibly induced by ILM removal.
• These findings contribute to understanding the biomechanical effects of ILM peeling on retinal architecture.