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Effect of internal limiting membrane peeling on normal retinal function evaluated by microperimetry-3
Yue Qi1, Zengyi Wang1, Shi-Ming Li1
1Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China.
Background:
To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3).
Methods:
This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function.
Results:
We incuded 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06 ± 0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53 ± 0.30, P < 0.01) and 4 months (0.31 ± 0.24, P < 0.01), respectively. Mean retinal sensitivity (MRS, dB) of the retina surrounding macular hole was 23.46 ± 3.01 dB at baseline, and significantly increased at 1 month (26.25 ± 2.31 dB, u = - 4.88, P < 0.01) and 4 months (27.14 ± 2.45 dB, t = - 6.29, P < 0.01). Patients with increased MRS are significantly younger than those with deceased MRS (59.72 ± 3.22 years vs. 65.60 ± 8.19 years, P < 0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than in superior and temporal retina at 1 and 4 months (P < 0.05).
Conclusion:
ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.
Insights
Internal limiting membrane (ILM) peeling during macular hole surgery improves retinal sensitivity without compromising function in the surrounding retina. This procedure demonstrates short-term safety and efficacy for retinal function assessment.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Visual Function Assessment
Background:
- Macular holes (MH) are a common cause of vision loss.
- Internal limiting membrane (ILM) peeling is a surgical technique used in MH repair.
- The effect of ILM peeling on surrounding retinal function requires evaluation.
Purpose of the Study:
- To assess the functional impact of ILM peeling on the retina surrounding macular holes.
- To evaluate changes in retinal sensitivity using microperimetry-3 (MP-3) post-surgery.
Main Methods:
- Prospective cohort study of 44 patients undergoing vitrectomy with ILM peeling for MH.
- Pre- and post-operative assessments included color fundus photography, OCT, and MP-3.
- MP-3 used a 45-spot pattern in the central 8° visual field, focusing on the perimacular area.
Main Results:
- Anatomical success was achieved in all eyes at 4 months.
- Best corrected visual acuity (BCVA) significantly improved post-operatively.
- Mean retinal sensitivity (MRS) in the surrounding retina significantly increased at 1 and 4 months (P<0.01).
- Younger patients showed greater MRS improvement.
- Increased MRS was more pronounced in the inferior and nasal retina.
Conclusions:
- ILM peeling in the normal retina does not impair short-term retinal function.
- The procedure is associated with improved retinal sensitivity in the perimacular area.
- Further research may explore long-term functional outcomes and regional differences.
