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Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery

Eye volume 37, pages 1451–1457 (2023)Cite this article

Subjects

Abstract

Objectives

To quantitatively evaluate concentric macular dark spots (CMDS) on spectral-domain optical coherence tomography (SD-OCT) to determine the morphological characteristics of dissociated optic nerve fibre layer (DONFL) following the performance of internal limiting membrane (ILM) peeling in patients with full-thickness idiopathic macular hole (IMH) closure.

Methods

Retrospective study on patients who underwent a vitrectomy with ILM peeling procedure. BCVA, cross-sectional OCT scans, and three-dimensional reconstructions of en face OCT scans were analysed preoperatively, at 2, 6, 12 months post-operatively. A novel image analysis technique was used to automatically measure DONFL logical properties through the radius, area, the nerve fibre layer dissociation index (NFLDI), and depth of the CMDS.

Results

53 eyes of 51 patients were included, and the mean follow-up was 11.53 ± 6.26 months. CMDS was found in 46 (86.79%) eyes within 2 months after ILM peeling and 50 (94.34%) eyes within 6 months after ILM peeling. CMDS concentrated on the temporal side of the macula in all 50 eyes (100%) at first detection. The area, NFLDI, and depth of CMDS in four quadrants developed significantly during the postoperative 6 months (p < 0.05), and then these changes slowed down and remained unchanged 12 months post-operatively. The morphological changes in the temporal quadrant were significantly greater than those in other quadrants at 2, 6, 12 months (all p < 0.05) post-operatively.

Conclusions

CMDS mostly appeared and concentrated on the temporal side of the macula in IMHs within two months after ILM peeling and progressed within 6 months and remained unchanged after 12 months.

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Fig. 1: Right eye of a 62-year-old woman was treated with vitrectomy and internal limiting membrane peeling for idiopathic macular hole.
Fig. 2: Workflow of image processing and automatically measurement of CMDS.
Fig. 3: Differences in the distribution of each parameter of DONFL in different quadrants were compared.
Fig. 4: Trends of changes in various parameters of CMDS during postoperative follow-ups.

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Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge Wenzhou's scientific research project (Y20190627). The sponsor or funding organisation had no role in the design or conduct of this research.

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Author notes

  1. These authors contributed equally: Xin Ye, Jiahao Xu.

Authors and Affiliations

  1. School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China

    Xin Ye, Shucheng He, Jun Wang, Jinglei Yang, Jiwei Tao, Yiqi Chen & Lijun Shen

  2. Department of Ophthalmology, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang, 312000, China

    Jiahao Xu

  3. Department of Ophthalmology, Zhejiang Provincial People’s Hospital, Hangzhou, China

    Yiqi Chen & Lijun Shen

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Contributions

SLJ had full access to all the data in the study and will take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YX, SLJ. Acquisition, analysis, or interpretation of data: YX, XJH, HSC, WJ, TJW, CYQ. Drafting of the manuscript: YX, XJH, HSC, WJ, YJL. Critical revision of the manuscript for important intellectual content: YX, SLJ. Study supervision: SLJ, CYQ.

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Correspondence to Yiqi Chen or Lijun Shen.

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Informed consent to publish was obtained from all of participants before their inclusion in the study.

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Ye, X., Xu, J., He, S. et al. Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery. Eye 37, 1451–1457 (2023). https://doi.org/10.1038/s41433-022-02150-y

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  • DOI: https://doi.org/10.1038/s41433-022-02150-y

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