Advances in the study of residual fragments in macular hole surgery_Chinese Journal of Ocular Fundus Diseases

Authors：

Xu Yijun , Tao Jiwei , Cheng Dan ,  Shen Lijun

The Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China;

Corresponding author：

Shen Lijun, Email: slj@mail.eye.ac.cn

Keywords：

Retinal perforations; Vitreoretinal surgery; Review; Residual fragments

DOI：

10.3760/cma.j.cn511434-20200710-00331

Video：

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Idiopathic macular hole after the internal limiting membrane (ILM) is removed during surgery, the intraoperative optical coherence tomography can be used to observe the presence of debris tissue (RF) protruding into the vitreous cavity at the edge of the hole. Current studies suggest that RF may be caused by epiretinal proliferation and vitreomacular traction, but it is still controversial, and the influence of postoperative anatomical and functional recovery is not clear. Common points can still be found, some of the studies suggest that RF is not conducive to postoperative anatomical and functional recovery during the operation, ILM fragments remain on RF tissues after ILM peeling and re-staining. However, in some studies suggest that RF is beneficial to postoperative anatomical and functional recovery, and ILM fragments on RF are removed. This suggests that whether ILM is removed on RF lead to a certain influence on the postoperative efficacy. There are few researches on RF at present, so it is necessary to understand RF from its essence and assist judgment through histological analysis.

Citation： Xu Yijun, Tao Jiwei, Cheng Dan, Shen Lijun. Advances in the study of residual fragments in macular hole surgery. Chinese Journal of Ocular Fundus Diseases, 2021, 37(4): 319-321. doi: 10.3760/cma.j.cn511434-20200710-00331 Copy

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5.	Takahashi H, Inoue M, Itoh Y, et al. Macular dehiscence-associated epiretinal proliferation in eyes with full-thickness macular hole[J]. Retina, 2020, 40(2): 273-281. DOI: 10.1097/IAE.0000000000002366.
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9.	Lai TT, Chen SN, Yang CM. Epiretinal proliferation in lamellar holes and full-thickness macular holes: clinical and surgical findings[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(4): 629-638. DOI: 10.1007/s00417-015-3133-9.
10.	Inoue M, Itoh Y, Koto T, et al. Intraoperative OCT findings may predict postoperative visual outcome in eyes with idiopathic macular hole[J]. Ophthalmol Retina, 2019, 3(11): 962-970. DOI: 10.1016/j.oret.2019.05.022.
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12.	Tao J, Chen H, Zhu L, et al. Macular hole edge morphology predicts restoration of postoperative retinal microstructure and functional outcome[J/OL]. BMC Ophthalmol, 2020, 20(1): 280[2020-07-11]. https://pubmed.ncbi.nlm.nih.gov/32652958/. DOI: 10.1186/s12886-020-01541-7.
13.	Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis[J]. Arch Ophthalmol, 1988, 106(5): 629-639. DOI: 10.1001/archopht.1988.01060130683026.
14.	Theodossiadis G, Petrou P, Eleftheriadou M, et al. Focal vitreomacular traction: a prospective study of the evolution to macular hole: the mathematical approach[J]. Eye (Lond), 2014, 28(12): 1452-1460. DOI: 10.1038/eye.2014.223.
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1. 陶继伟, 王奇骅, 褚梦琪, 等. 手术中光相干断层扫描在玻璃体视网膜手术中应用的初步观察报告[J]. 中华眼底病杂志, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.Tao JW, Wang QH, Chu MQ, et al. The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.
2. Kumar V, Yadav B. Hole-door sign: a novel intraoperative optical coherence tomography feature predicting macular hole closure[J]. Retina, 2018, 38(10): 2045-2050. DOI: 10.1097/IAE.0000000000001791.
3. Son G, Lee JS, Lee S, et al. Epiretinal proliferation associated with macular hole and intraoperative perifoveal crown phenomenon[J]. Korean J Ophthalmol, 2016, 30(6): 399-409. DOI: 10.3341/kjo.2016.30.6.399.
4. Pang CE, Spaide RF, Freund KB. Epiretinal proliferation seen in association with lamellar macular holes: a distinct clinical entity[J]. Retina, 2014, 34(8): 1513-1523. DOI: 10.1097/IAE.0000000000000163.
5. Takahashi H, Inoue M, Itoh Y, et al. Macular dehiscence-associated epiretinal proliferation in eyes with full-thickness macular hole[J]. Retina, 2020, 40(2): 273-281. DOI: 10.1097/IAE.0000000000002366.
6. Itoh Y, Levison A, Kaiser P, et al. Prevalence and characteristics of hyporeflective preretinal tissue in vitreomacular interface disorders[J]. Br J Ophthalmol, 2016, 100(3): 399-404. DOI: 10.1136/bjophthalmol-2015-306986.
7. Compera D, Entchev E, Haritoglou C, et al. Lamellar hole-associated epiretinal proliferation in comparison to epiretinal membranes of macular pseudoholes[J]. Am J Ophthalmol, 2015, 160(2): 373-384. DOI: 10.1016/j.ajo.2015.05.010.
8. Kenawy N, Wong D, Stappler T, et al. Does the presence of an epiretinal membrane alter the cleavage plane during internal limiting membrane peeling?[J]. Ophthalmology, 2010, 117(2): 320-323. DOI: 10.1016/j.ophtha.2009.07.024.
9. Lai TT, Chen SN, Yang CM. Epiretinal proliferation in lamellar holes and full-thickness macular holes: clinical and surgical findings[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(4): 629-638. DOI: 10.1007/s00417-015-3133-9.
10. Inoue M, Itoh Y, Koto T, et al. Intraoperative OCT findings may predict postoperative visual outcome in eyes with idiopathic macular hole[J]. Ophthalmol Retina, 2019, 3(11): 962-970. DOI: 10.1016/j.oret.2019.05.022.
11. Parolini B, Schumann RG, Cereda MG, et al. Lamellar macular hole: a clinicopathologic correlation of surgically excised epiretinal membranes[J]. Invest Ophthalmol Vis Sci, 2011, 52(12): 9074-9083. DOI: 10.1167/iovs.11-8227.
12. Tao J, Chen H, Zhu L, et al. Macular hole edge morphology predicts restoration of postoperative retinal microstructure and functional outcome[J/OL]. BMC Ophthalmol, 2020, 20(1): 280[2020-07-11]. https://pubmed.ncbi.nlm.nih.gov/32652958/. DOI: 10.1186/s12886-020-01541-7.
13. Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis[J]. Arch Ophthalmol, 1988, 106(5): 629-639. DOI: 10.1001/archopht.1988.01060130683026.
14. Theodossiadis G, Petrou P, Eleftheriadou M, et al. Focal vitreomacular traction: a prospective study of the evolution to macular hole: the mathematical approach[J]. Eye (Lond), 2014, 28(12): 1452-1460. DOI: 10.1038/eye.2014.223.
15. Tsai CY, Hsieh YT, Lai T, et al. Idiopathic macular holes and direction of vitreomacular traction: structural changes and surgical outcomes[J]. Eye (Lond), 2017, 31(12): 1689-1696. DOI: 10.1038/eye.2017.141.

Chinese Journal of Ocular Fundus Diseases

Advances in the study of residual fragments in macular hole surgery

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