title: Tomographic features of macula after successful macular hole surgery.
abstract: OBJECTIVE
  We determined the retinal features associated with a dissociated optic nerve fiber layer (DONFL) appearance after successful macular hole surgery with internal limiting membrane (ILM) peeling.
  
  
  METHODS
  A tota of 47 eyes of 47 patients who underwent pars plana vitrectomy with ILM peeling was examined by spectral-domain optical coherence tomography (SD-OCT).
  
  
  RESULTS
  A DONFL appearance was found in 31 (66.0%) eyes on color fundus photography. The postoperative best-corrected visual acuity and its improvements were not significantly different between eyes with and without this appearance. The SD-OCT images showed small inner retinal defects corresponding to each arcuate stria in all eyes with the DONFL appearance. Of these eyes, 25 (80.6%) included inner retinal defects extending beyond the retinal nerve fiber layer (RNFL) into the ganglion cell layer and inner plexiform layer. Similar inner retinal defects were seen in 14 (87.5%) of the 16 eyes without a DONFL appearance; 10 eyes (62.5%) included the defects that extended deeper than the RNFL. Such deep defects were found more frequently in the temporal than in the other quadrants (P < 0.0001). In 10 eyes that underwent Micro Perimeter-1, a reduction in retinal sensitivity (<10 dB) was found in 20 (10.4%) of the 192 points on arcuate striae, but only in 7 (3.4%) of 208 points away from the striae (P = 0.005).
  
  
  CONCLUSIONS
  Macular hole surgery with ILM peeling may lead to deep inner retinal damage regardless of the development of the DONFL appearance detected on color fundus photography.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nukada
authors.forename: Masanori
authors.initials: M
authors.lastname: Hangai
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.forename: Munemitsu
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009900:Optic Nerve / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012167:Retinal Perforations / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy