title: Delayed onset inner nuclear layer cystic changes following internal limiting membrane removal for epimacular membrane.
abstract: OBJECTIVE
  To report the rare occurrence of new inner nuclear layer cystic spaces occurring in eyes treated with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) removal for idiopathic epimacular membrane (EMM).
  
  
  METHODS
  Consecutive patients with EMM without preoperative retinal cystic changes undergoing PPV with ILM peeling were retrospectively evaluated. Patients developing a characteristic inner nuclear layer cystic change were analyzed.
  
  
  RESULTS
  Inner nuclear layer cystic changes appeared in eight of 768 (1.04 %) eyes at a mean postoperative time period of 3.2 ± 0.89 months. No leakage or pooling was demonstrated on postoperative fluorescein angiography. Morphologic characteristics included vertically elongated hyporeflectant spaces within the inner nuclear layer on spectral domain optical coherence tomography (SD-OCT).
  
  
  CONCLUSIONS
  A minority of patients undergoing PPV with ILM peeling develop new, delayed onset, postoperative inner nuclear layer cystic spaces with a characteristic SD-OCT appearance and no evidence of angiographic leakage.
authors.affiliation: Charles Retina Institute, 6401 Poplar Ave., suite 190, Memphis, TN 38119, USA. ejsigler@gmail.com
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Sigler
authors.forename: John C
authors.initials: JC
authors.lastname: Randolph
authors.forename: Steve
authors.initials: S
authors.lastname: Charles
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy