title: Retinal nerve fiber layer thickness modification after internal limiting membrane peeling.
abstract: OBJECTIVE
  To identify early and late retinal nerve fiber layer thickness (RNFLT) modification after internal limiting membrane peeling for idiopathic macular hole or epiretinal membrane and to correlate RNFLT to visual field indices.
  
  
  METHODS
  Single-center, prospective, interventional consecutive case series. Complete ophthalmic examination, fundus images, and spectral domain optical coherence tomography were performed in 30 eyes of 30 patients before and 1, 3, and 6 months after surgery. Six peripapillary sectors (superotemporal, temporal, inferotemporal, inferonasal, nasal, superonasal) and global RNFLT were evaluated. Visual field was performed preoperatively and 6 months postoperatively.
  
  
  RESULTS
  Significant RNFLT modification was found after surgery (P < 0.0001). Specifically, RNFLT significantly increased in all, but the temporal sectors, 1 month after surgery, and it returned to preoperative values at the third month. Six months after surgery, RNFLT was lower than basal values in the superotemporal, inferotemporal, and temporal sectors (P < 0.001, P < 0.05, and P < 0.001, respectively) with an average reduction of 18.2 ± 9.8 µm. No correlation was found between RNFLT and the visual field indices.
  
  
  CONCLUSIONS
  The diffuse RNFLT increase 1 month postoperatively could be because of inflammatory responses. The reduction of RNFLT in the temporal sectors 6 months postoperatively could indicate damage to the macular retinal nerve fiber layer caused by internal limiting membrane peeling.
authors.affiliation: *Ophthalmology Unit, University of Bologna, Bologna, Italy; †Ophthalmology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy; and ‡San Giuseppe Hospital, University Eye Clinic, Milan, Italy.
authors.forename: Nicole
authors.initials: N
authors.lastname: Balducci
authors.forename: Mariachiara
authors.initials: M
authors.lastname: Morara
authors.forename: Chiara
authors.initials: C
authors.lastname: Veronese
authors.forename: Carlo
authors.initials: C
authors.lastname: Torrazza
authors.forename: Francesco
authors.initials: F
authors.lastname: Pichi
authors.forename: Antonio P
authors.initials: AP
authors.lastname: Ciardella
mesh_terms: D000368:Aged; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D018918:Phacoemulsification; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012167:Retinal Perforations / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014794:Visual Fields / Q000502:physiology; D014821:Vitrectomy