Abstract
Purpose
To present two patients who underwent surgery for an idiopathic macular hole (IMH) with internal limiting membrane (ILM) peeling and developed an epimacular proliferative response.
Methods
Observational case report. Two patients with an IMH underwent pars plana vitrectomy with ILM peeling. Ophthalmic examination including optical coherence tomography (OCT) was performed pre- and postoperatively. In both cases, scanning laser ophthalmoscopy (SLO) was performed postoperatively.
Results
In the first case, the closure of the macular hole (MH) was confirmed ophthalmoscopically and by OCT following the surgery. At 2 months postoperatively, a thin epiretinal membrane (ERM) developed over the nasal macula area where the ILM had been peeled. The patient’s visual acuity had recovered to 1.0 but she complained of metamorphopsia. At 18 months postoperatively, the thin ERM around the nasal fovea remained and her visual acuity was still 1.0. In the second case, the MH was sealed after the surgery, and the patient’s visual acuity had improved to 1.0 at 3 months, but an indistinct ERM developed in the macular region where the ILM had been peeled. Two years after the operation, her VA was still 1.0. One and two years postoperatively, a thin epimacular proliferation remained unchanged; in addition, the OCT and SLO images remained stable.
Conclusion
Two patients who underwent IMH surgery with ILM peeling developed an epimacular proliferative response postoperatively. We suggest that the injury associated with the ILM peeling may have stimulated glial proliferation.
References
Books HL (2000) Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 107:1939–1949
Funata M, Wendel RT, de la Cruz Z, Green WR (1992) Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade. Retina 12:289–298
Kadonosono K, Itoh N, Uchio E, Nakamura S, Ohno S (2000) Staining of internal limiting membrane in macular hole surgery. Arch Ophthalmol 118:1116–1118
Kwok AK, Li WW, Pang CP, Lai TY, Yam GH, Chan NR, Lam DS (2001) Indocyanine green staining and removal of internal limiting membrane in macula hole surgery: histology and outcome. Am J Ophthalmol 132:178-183
Madreperla SA, Geiger GL, Funata M, de la Cruz Z, Green WR (1994) Clinicopathologic correlation of a macular hole treated by cortical vitreous peeling and gas tamponade. Ophthalmology 101:682–686
Mester V, Kuhn F (2000) Internal limiting membrane removal in the management of the full-thickness macular holes. Am J Ophthalmol 129:769-777
Park DW, Sipperley JO, Sneed SR, Dugel PU, Jacobsen J (1999) Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology 106:1392-1397 (discussion 1397–1398)
Wendel RT, Patel AC, Kelly NE, Salzano TC, Wells JW, Novack GD (1993) Vitreous surgery for macular hole. Ophthalmology 100:1671–1676
Author information
Authors and Affiliations
Corresponding author
Additional information
Proprietary interest: None of the authors or any of their family members has any proprietary or financial interest in the instruments used in this study
This study has not been published elsewhere or presented at any meeting
Rights and permissions
About this article
Cite this article
Uemoto, R., Yamamoto, S. & Takeuchi, S. Epimacular proliferative response following internal limiting membrane peeling for idiopathic macular holes. Graefe's Arch Clin Exp Ophthalmol 242, 177–180 (2004). https://doi.org/10.1007/s00417-003-0804-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-003-0804-8