Regional Reduction of Ganglion Cell Complex after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Hole

Abstract

Purpose. To determine whether the reduction of ganglion cell complex (GCC) thickness is uniform in the parafoveal region after vitrectomy with internal limiting membrane (ILM) peeling for idiopathic macular hole (MH).Methods. Thirty-nine consecutive eyes were studied. Vitrectomy was performed with ILM peeling with brilliant blue G (BBG) staining, and room air was used for an intraocular tamponade. The GCC thickness and retinal sensitivity were measured at the superior, inferior, nasal, and temporal quadrants around the fovea using spectral domain-optical coherence tomography (SD-OCT) and microperimetry (MP-1). The measurements were made at baseline, and at 3 and 6 months postoperatively.Results. In 38 of the 39 eyes, the MH was closed after the initial surgery. At three and six months, the percentage of eyes with significantly thinner GCC areas was higher at the temporal quadrant (40.5% at 3 months and 46.0% at 6 months) than that at the other quadrants (P<0.001, P<0.001, resp.). The retinal sensitivity was also significantly lower in the temporal area than in the other areas (15.7 dB at 3 months,P=0.003; 15.4 dB at 6 months,P=0.006).Conclusion. These findings indicate that the inner retina in the temporal area may be more vulnerable to surgical manipulations than the other areas.