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Paracentral retinal holes occurring after macular surgery: incidence, clinical features, and evolution

  • Retinal Disorders
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Abstract

Aim

To describe the incidence, clinical features, and evolution of paracentral retinal holes occurring after macular surgery.

Methods

A retrospective non-randomized study of 909 patients operated on for either a macular hole (MH, n = 400 patients) or an epiretinal membrane (ERM, n = 509 patients) between 2004 and 2009. Six patients (0.6%) developed a paracentral macular hole after surgery. Their clinical, auto-fluorescence, and optical coherence tomography (OCT) characteristics as well as their visual outcomes were studied.

Results

The mean age of patients was 70 years. Paracentral holes occurred approximately 5 weeks after surgery (with a range of 2–12 weeks). All patients were asymptomatic. Five patients underwent ILM peeling during initial surgery. Paracentral retinal holes were located superiorly to the fovea in three cases and temporally in the other three cases. Mean pre-operative BCVA was 20/200 and mean post-operative BCVA was 20/40. The eye where the eccentric MHs were closest to the fovea (inferior to 1 optic disc area) had the poorest final visual acuity. Autofluorescence imaging showed a bright fluorescence in paramacular holes. On OCT images, they were shown to be flat full-thickness holes. No treatment was attempted. No rhegmatogenous complications or choroidal neovascularization occurred in any of the patients. Mean follow-up was 2 years.

Conclusions

In summary, paracentral MHs are uncommon complications which can occur at the site where ILM peeling has been initiated or completed. Except for the closest holes to fovea, they have good visual prognosis and do not require any treatment underlining the importance of initiating the ILM peeling as far as possible from the fovea.

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References

  1. Machemer R (1974) A new concept for vitreous surgery. 7. Two instrument techniques in pars plana vitrectomy. Arch Ophthalmol 92:407–412

    Article  PubMed  CAS  Google Scholar 

  2. Michels RG (1984) Vitrectomy for macular pucker. Ophthalmology 91:1384–1388

    PubMed  CAS  Google Scholar 

  3. Margherio RR, Cox MS Jr, Trese MT, Murphy PL, Johnson J, Minor LA (1985) Removal of epimacular membranes. Ophthalmology 92:1075–1083

    PubMed  CAS  Google Scholar 

  4. Sandali O, El Sanharawi M, Lecuen N, Barale PO, Bonnel S, Basli E, Borderie V, Laroche L, Monin C (2011) 25-, 23-, and 20-gauge vitrectomy in epiretinal membrane surgery: a comparative study of 553 cases. Graefes Arch Clin Exp Ophthalmol 249:1811–1819

    Article  PubMed  Google Scholar 

  5. Sandali O, Basli E, Borderie V, Laroche L, Monin C (2011) Recurrence of an idiopathic vasocentric epiretinal membrane: clinical and surgical particularities. J Fr Ophtalmol. PMID: 21719147. doi:10.1016/j.jfo.2011.02.011

  6. Scott IU, Flynn HW Jr, Acar N, Dev S, Shaikh S, Mittra RA, Arevalo JF, Kychenthal A, Kunselman A (2011) Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 249:377–380

    Article  PubMed  Google Scholar 

  7. Haritoglou C, Ehrt O, Gass CA, Kristin N, Kampik A (2001) Paracentral scotomata: a new finding after vitrectomy for idiopathic macular hole. Br J Ophthalmol 85:231–233

    Article  PubMed  CAS  Google Scholar 

  8. Al-Abdulla NA, Thompson JT, Sjaarda RN (2004) Results of macular hole surgery with and without epiretinal dissection or internal limiting membrane removal. Ophthalmology 111:142–149

    Article  PubMed  Google Scholar 

  9. Pournaras CJ, Emarah A, Petropoulos IK (2011) Idiopathic macular epiretinal membrane surgery and ILM peeling: anatomical and functional outcomes. Semin Ophthalmol 26:42–46

    Article  PubMed  Google Scholar 

  10. Rubinstein A, Bates R, Benjamin L, Shaikh A (2005) Iatrogenic eccentric full thickness macular holes following vitrectomy with ILM peeling for idiopathic macular holes. Eye 19:1333–1335

    Article  PubMed  CAS  Google Scholar 

  11. Steven P, Laqua H, Wong D, Hoerauf H (2006) Secondary paracentral retinal holes following internal limiting membrane removal. Br J Ophthalmol 90:293–295

    Article  PubMed  CAS  Google Scholar 

  12. Mason JO 3rd, Feist RM, Albert MA Jr (2007) Eccentric macular holes after vitrectomy with peeling of epimacular proliferation. Retina 27:45–48

    Article  PubMed  Google Scholar 

  13. Gass CA, Haritoglou C, Schaumberger M, Kampik A (2003) Functional outcome of macular hole surgery with and without indocyanine green-assisted peeling of the internal limiting membrane. Graefes Arch Clin Exp Ophthalmol 241:716–720

    Article  PubMed  Google Scholar 

  14. Tognetto D, Grandin R, Sanguinetti G, Minutola D, Di Nicola M, Di Mascio R, Ravalico G, Macular Hole Surgery Study Group (2006) Internal limiting membrane removal during macular hole surgery: results of a multicenter retrospective study. Ophthalmology 113:1401–1410

    Article  PubMed  Google Scholar 

  15. Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M (2009) Double staining with brilliant blue G and double peeling for epiretinal membranes. Ophthalmology 116:1370–1376

    Article  PubMed  Google Scholar 

  16. Schadlu R, Tehrani S, Shah GK, Prasad AG (2008) Long-term follow-up results of ILM peeling during vitrectomy surgery for premacular fibrosis. Retina 28:853–857

    Article  PubMed  Google Scholar 

  17. Lim JW, Cho JH, Kim HK (2010) Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with internal limiting membrane peeling. Clin Ophthalmol 30:689–694

    Article  Google Scholar 

  18. Lai TY, Kwok AK, Au AW, Lam DS (2007) Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling. Graefes Arch Clin Exp Ophthalmol 245:148–154

    Article  PubMed  Google Scholar 

  19. Karacorlu M, Karacorlu S, Ozdemir H (2003) Iatrogenic punctate chorioretinopathy after internal limiting membrane peeling. Am J Ophthalmol 135:178–182

    Article  PubMed  Google Scholar 

  20. Kawaji T, Hirata A, Inomata Y, Koga T, Tanihara H (2004) Morphological damage in rabbit retina caused by subretinal injection of indocyanine green. Graefes Arch Clin Exp Ophthalmol 242:158–164

    Article  PubMed  Google Scholar 

  21. Gandorfer A, Haritoglou C, Kampik A (2008) Toxicity of indocyanine green in vitreoretinal surgery. Dev Ophthalmol 42:69–81

    Article  PubMed  CAS  Google Scholar 

  22. Enaida H, Ishibashi T (2008) Brilliant blue in vitreoretinal surgery. Dev Ophthalmol 42:115–125

    Article  PubMed  CAS  Google Scholar 

  23. Eckardt C, Eckardt U, Groos S, Luciano L, Reale E (1997) Removal of the internal limiting membrane in macular holes. Clinical and morphological findings. Ophthalmologe 94:545–551

    Article  PubMed  CAS  Google Scholar 

  24. Wolf S, Schnurbusch U, Wiedemann P, Grosche J, Reichenbach A, Wolburg H (2004) Peeling of the basal membrane in the human retina: ultrastructural effects. Ophthalmology 111:238–243

    Article  PubMed  Google Scholar 

  25. Uemoto R, Yamamoto S, Takeuchi S (2004) Epimacular proliferative response following internal limiting membrane peeling for idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 242:177–180

    Article  PubMed  Google Scholar 

  26. Johnson MW (2005) Perifoveal vitreous detachment and its macular complications. Trans Am Ophthalmol Soc 103:537–567

    PubMed  Google Scholar 

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Conflicts of interest

The authors have no proprietary, commercial, or financial interests in any of the products described in this study.

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Authors and Affiliations

  1. Centre Hospitalier National d’Ophtalmologie des XV-XX, 28 rue de Charenton, 75571, Paris, France

    Otman Sandali, Mohamed El Sanharawi, Elena Basli, Nicolas Lecuen, Sebastien Bonnel, Vincent Borderie, Laurent Laroche & Claire Monin

Authors
  1. Otman Sandali
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  2. Mohamed El Sanharawi
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  3. Elena Basli
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  4. Nicolas Lecuen
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  5. Sebastien Bonnel
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  6. Vincent Borderie
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  7. Laurent Laroche
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  8. Claire Monin
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Correspondence to Otman Sandali.

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Sandali, O., El Sanharawi, M., Basli, E. et al. Paracentral retinal holes occurring after macular surgery: incidence, clinical features, and evolution. Graefes Arch Clin Exp Ophthalmol 250, 1137–1142 (2012). https://doi.org/10.1007/s00417-012-1935-6

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  • DOI: https://doi.org/10.1007/s00417-012-1935-6

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