Post-operative role of OCT and OCTA in the evaluation of idiopathic macular hole surgery, anatomic versus functional success. A review article
Main Article Content
Abstract
Purpose: To evaluate the role of OCT and OCTA as prognostic tools in the evaluation of the results of idiopathic macular hole surgery from the anatomical and functional points of view.
Methods: This is a review article gathering the conclusions of many articles in the literature discussing this important issue.
Results: The integrity of the external limiting membrane and the ellipsoid zone were found to be the most important prognostic criteria for visual recovery. A U-type shape pattern of closure and a flat closed closure were also associated with a favorable visual gain. On the other hand, retinal displacement following surgery may be responsible for post operative residual metamorphopsia. A foveal hyper-reflective lesion during the healing process and age-related sub foveal deposits are poor prognostic signs for visual improvement. An early post operative appearance of a foveal detachment, outer foveolar defects or signs of a dissociated optic nerve fiber layer were not found to be important signs in the determination of the final post operative visual acuity.
Conclusion: OCT and OCTA proved to be very beneficial in the evaluation of the macular status following successful macular hole (MH) surgery and in linking the anatomic success criteria to the expected functional status.
Keywords:
OCT, OCTA, idiopathic macular hole, macular hole closure, macular hole surgery, vitrectomy
Article Details
How to Cite
DARWISH, Ahmed.
Post-operative role of OCT and OCTA in the evaluation of idiopathic macular hole surgery, anatomic versus functional success. A review article.
Medical Research Archives, [S.l.], v. 13, n. 10, nov. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7015>. Date accessed: 15 nov. 2025.
doi: https://doi.org/10.18103/mra.v13i10.7015.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1) Fallico M, et al. Factors predicting normal visual acuity following anatomically successful macular hole surgery. Acta Ophthalmol. 2021;99(3):e324-e329. doi: 10.1111/aos.14575.
2) Cicinelli MV, Marchese A, Bandello F, e al. Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography. J Ophthalmol. 2019; 2019:3821479. doi: 10.1155/2019/3821479.
3) Singh S, Saxena S, Meyer CH, e al. Retinal photoreceptor ellipsoid zone is a structural biomarker for visual outcome after successful macular hole surgery: A novel grading system-based study. Indian J Ophthalmol. 2025;73(Suppl 1):S126-S131. doi: 10.4103/IJO.IJO_1031_24.
4) Baba T, Yamamoto S, Arai M, et al. Correlation of visual recovery and presence of photoreceptor inner/outer segment junction in optical coherence images after successful macular hole repair. Retina. 2008;28(3):453-8. doi: 10.1097/IAE.0b013e3181571398.
5) Saxena S, Ruia S, Prasad S, et al. Increased serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor external limiting membrane and inner segment ellipsoid zone in type 2 diabetes mellitus. Retina. 2017;37 (2):344-349. doi: 10.1097/IAE.0000000000001163.
6) Jain A, Saxena S, Khanna VK, et al. Status of serum VEGF and ICAM-1 and its association with external limiting membrane and inner segment-outer segment junction disruption in type 2 diabetes mellitus. Mol Vis 2013; 19:1760–8. http://www.molvis.org/molvis/v19/1760 .
7) Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: Spectral-domain optical coherence tomographic analysis. Ophthalmology. 2010;117:1 815-24. doi: 10.1016/j.ophtha.2010.01.017.
8) Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Schuman JS, Swanson EA, Fujimoto JG. Optical coherence tomography of macular holes. Ophthalmology. 1995 May;102(5):748-56. doi: 10.1016/s0161-6420 (95)30959-1. PMID: 7777274.
9) Sano M, Shimoda Y, Hashimoto H, Kishi S. Restored photoreceptor outer segment and visual recovery after macular hole closure. Am J Ophthalmol. 2009;147(2):313-318.e1. doi: 10.1016 /j.ajo.2008.08.002.
10) Mansour AM, Parodi M, Uwaydat SH, et al. Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review. J Ophthalmic Vis Res. 2023;18(4):424-432. doi: 10.18502/jovr. v18i4.14555.
11) Mahmoud TH, McCuen BW 2nd. Natural history of foveolar lucencies observed by optical coherence tomography after macular hole surgery. Retina. 2007;27(1):95-100. doi: 10.1097/01.iae.000 0223758.17543.49.
12) Oh J, Smiddy WE, Flynn HW Jr, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery. Invest Ophthalmol Vis Sci. 2010;51(3) :1651-8. doi: 10.1167/iovs.09-4420.
13) Goldberg JL, Klassen MP, Hua Y, et al. Amacrine-signaled loss of intrinsic axon growth ability by retinal ganglion cells. Science. 2002;296 (5574):1860-4. doi: 10.1126/science.1068428.
14) Shewan D, Berry M, Cohen J. Extensive regeneration in vitro by early embryonic neurons on immature and adult CNS tissue. J Neurosci. 1995;15(3 Pt 1):2057-62. doi: 10.1523/JNEUROSCI .15-03-02057.1995.
15) Li D, Field PM, Raisman G. Failure of axon regeneration in postnatal rat entorhinohippocampal slice coculture is due to maturation of the axon, not that of the pathway or target. Eur J Neurosci. 1995;7(6):1164-71. doi: 10.1111/j.1460-9568. 1995 .tb01106. x.
16) Celsi F, Pizzo P, Brini M, et al. Mitochondria, calcium and cell death: a deadly triad in neurodegeneration. Biochim Biophys Acta. 2009; 1787:335–344. doi: 10.1016/j.bbabio.2009.02.021.
17) Kim Y, Kim ES, Yu SY, et al. Age-related clinical outcome after macular hole surgery. Retina. 2017; 37(1):80-87. doi: 10.1097/IAE.0000000000001162.
18) Chinnery HR, McLenachan S, Humphries T, et al. Accumu lation of murine subretinal macrophages: effects of age, pigmentation and CX3CR1. Neurobiol Aging. 2012;33(8):1769-76. doi: 10.1016/j.neurobi olaging.2011.03.010.
19) Cornish K, Lois N, Scott N, et al. Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH). Cochrane Database Syst Rev. 2013;(6):CD009306. doi: 10.10 02/14651858.CD009306.pub2.
20) Brooks HL Jr. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology. 2000;107(10):1939-48; discussion 1948-9. doi: 10.1016/s0161-6420(00)00331-6.
21) Yoshida M, Kishi S. Pathogenesis of macular hole recurrence and its prevention by internal limiting membrane peeling. Retina. 2007;27(2):169 -73. doi: 10.1097/01.iae.0000224940. 79223.fb.
22) Simon GJ, Desatnik H, Alhalel A, et al. Retrospective analysis of vitrectomy with and without internal limiting membrane peeling for stage 3 and 4 macular hole. Ophthalmic Surg Lasers Imaging. 2004;35(2):109-15. PMID: 15088820.
23) Haritoglou C, Reiniger IW, Schaumberger M, et al. Five-year follow-up of macular hole surgery with peeling of the internal limiting membrane: update of a prospective study. Retina. 2006; 26(6): 618-22. doi: 10.1097/01.iae.0000236474.63819.3a.
24) Christensen UC. Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology. Acta Ophthalmol. 2009; 87 Thesis 2:1-23. doi: 10.1111/j.1755-3768.2009.01777. x.
25) Baba T, Sato E, Oshitari T, Yamamoto S. Regional reduction of ganglion cell complex after vitrectomy with internal limiting membrane peeling for idiopathic macular hole. J Ophthalmol. 2014; 2014:372589. doi: 10.1155/2014/372589.
26) Sabater AL, Velázquez-Villoria Á, Zapata MA, et al. Evaluation of macular retinal ganglion cell-inner plexiform layer thickness after vitrectomy with internal limiting membrane peeling for idiopathic macular holes. Biomed Res Int. 2014; 2014:45863 1. doi: 10.1155/2014/458631.
27) Clark A, Balducci N, Pichi F, et al. Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling. Retina. 2012;32(8):1608-13. doi: 10.1097/IAE.0b013e3182437e86.
28) Balducci N, Morara M, Veronese C, et al. Retinal nerve fiber layer thickness modification after internal limiting membrane peeling. Retina. 2014; 34(4):655-63. doi: 10.1097/IAE.0000000000000004
29) Kumagai K, Ogino N, Furukawa M, et al. Retinal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane. Clin Ophthalmol. 2012; 6:679-88. doi: 10.2147/OPTH.S30288.
30) Ye X, Xu J, He S, et al. Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery. Eye (Lond). 2023;37(7):1451-1457. doi: 10.1038/s4143 3-022-02150-y.
31) He S, Ye X, Qiu W, et al. Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study. J Pers Med. 2023; 13(2):255. doi: 10.3390/jpm13020255.
32) Sabry D, El-Kannishy A, Kamel R, et al. Correlation between en face optical coherence tomography defects of the inner retinal layers and ganglion cell inner plexiform layer analysis after internal limiting membrane peeling for idiopathic full-thickness macular hole. Invest Ophthalmol Vis Sci. 2016;57(9):444-50. doi: 10.1167/iovs.15-18043.
33) Ito Y, Terasaki H, Takahashi A. Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes. Ophthalmology. 2005; 112(8):1415-20. doi: 10.1016/j.ophtha.2005.02.023.
34) Takai Y, Tanito M, Sugihara K, et al. Temporal inverted internal limiting membrane flap technique for a macular hole patient unable to maintain postoperative prone positioning. Retin Cases Brief Rep. 2016:10(4):323-6. doi: 10.1097/ICB.0000000 000000258.
35) Michalewska Z, Michalewski J, Nawrocki J, et al. Temporal inverted internal limiting membrane flap technique versus classic inverted internal limiting membrane flap technique: a comparative study. Retina. 2015; 35(9):1844-50. doi: 10.1097/ IAE.0000000000000555.
36) Hirata A, Mine K, Hayashi K. Contractility of temporal inverted internal limiting membrane flap after vitrectomy for macular hole. Sci Rep. 2021 ;11(1):20035. doi: 10.1038/s41598-021-99509-0.
37) Sakimoto S, Ikuno Y, Fujimoto S, et al. Characteristics of the retinal surface after internal limiting membrane peeling in highly myopic eyes. Am J Ophthalmol. 2014;158(4):762-768.e1. doi: 10.1016/j.ajo.2014.06.024.
38) Kim KY, Yu SY, Kim M, et al. Morphological change of inner retinal layer on spectral-domain optical coherence tomography following macular hole surgery. Ophthalmologica. 2013;230(1):18-26. doi: 10.1159/000350552.
39) Steel DH, Dinah C, Habib M, et al. ILM peeling technique influences the degree of a dissociated optic nerve fiber layer appearance after macular hole surgery. Graefes Arch Clin Exp Ophthalmol. 2015;253(5):691-8. doi: 10.1007/s00417-014-2734-z.
40) Nukada K, Hangai M, Ooto S, et al. Tomographic features of macula after successful macular hole surgery. Invest Ophthalmol Vis Sci. 2013;54(4):2417-28. doi: 10.1167/iovs.12-10838.
41) Spaide RF. "Dissociated optic nerve fiber layer appearance" after internal limiting membrane removal is inner retinal dimpling. Retina. 2012;32 (9):1719-26. doi: 10.1097/IAE.0b013e3182671191.
42) Ikeda T, Nakamura K, Sato T, et al. Involvement of anoikis in dissociated optic nerve fiber layer appearance. Int J Mol Sci. 2021;22(4):1724. doi: 10.3390/ijms22041724.
43) Kim YH, Song MS, Togloom A, et al. Bidirectional dimples after internal limiting membrane peeling for a macular hole. Transl Vis Sci Technol. 2023;12(5):23. doi: 10.1167/tvst.12.5.23.
44) Steel DH, Dinah C, White K, et al. The relationship between a dissociated optic nerve fibre layer appearance after macular hole surgery and Muller cell debris on peeled internal limiting membrane. Acta Ophthalmol. 2017;95(2):153-157. doi: 10.1111/aos.13195.
45) Tao J, Yang J, Wu Y, et al. Internal limiting membrane peeling distorts the retinal layers and induces scotoma formation in the perifoveal temporal macula. Retina. 2022;42(12):2276-2283. doi: 10.1097/IAE.0000000000003619.
46) Balducci N, Morara M, Veronese C, et al. Retinal nerve fiber layer thickness modification after internal limiting membrane peeling. Retina 2014; 34(4):655-63. doi: 10.1097/IAE.0000000000000004.
47) Modi A, Giridhar A, Gopalakrishnan M. Spectral domain optical coherence tomography–based microstructural analysis of retinal architecture post internal limiting membrane peeling for surgery of idiopathic macular hole repair. Retina. 2017;37(2):291-298. doi: 10.1097/ IAE.0000000000001129.
48) Farah ME, Maia M, Rodrigues EB. Dyes in ocular surgery: principles for use in chromovitrectomy. Am J Ophthalmol. 2009;148(3):332-40. doi: 10.10 16/j.ajo.2009.04.003.
49) Piccirillo V, Sbordone S, Sorgente F, et al. Evaluation of efficacy and safety of new high-density dyes for chromovitrectomy. Sci Rep. 2021; 11(1):15171. doi: 10.1038/s41598-021-94770-9.
50) Takamura Y, Tomomatsu T, Matsumura T, et al. Correlation between central retinal thickness after successful macular hole surgery and visual outcome. Jpn J Ophthalmol. 2015;59(6):394-400. doi: 10.1007/s10384-015-0406-0.
51) Wollensak G, Spoerl E, Grosse G, et al. Biomechanical significance of the human internal limiting lamina. Retina. 2006;26(8):965-8. doi: 10.1097/01.iae.0000250001.45661.95.
52) Hogan MJ, Alvarado JA, Weddell JE. Histology of the Human Eye.An atlas and textbook Philadelphia: WB Saunders Company. (1971), 523–606. DOI:10. 1001/jama.1972.03190280059024 Corpus ID: 72719454
53) Goto K, Iwase T, Akahori T, et al. Choroidal and retinal displacements after vitrectomy with internal limiting membrane peeling in eyes with idiopathic macular hole. Sci Rep. 2019;9(1):17568. doi: 10.1038/s41598-019-54106-0.
54) Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003;87(8):1015-9. doi: 10.1136/bjo.87.8.1015.
55) Imai M, Iijima H, Gotoh T, et al. Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol. 1999;128(5):621-7. doi: 10.1016/s0002-9394(99)00200-7.
56) Tornambe PE, Poliner LS, Cohen RG. Definition of macular hole surgery end points: elevated/open, flat/open, flat/closed. Retina. 1998;18(3):286-7. doi: 10.1097/00006982-199803000-00021.
57) Hillenkamp J, Kraus J, Framme C, et al. Retreatment of full-thickness macular hole: predictive value of optical coherence tomography. Br J Ophthalmol. 2007;91(11):1445-9. doi: 10.1136/bjo.2007.115642.
58) D'Souza MJ, Chaudhary V, Devenyi R, et al. Re-operation of idiopathic full-thickness macular holes after initial surgery with internal limiting membrane peel. Br J Ophthalmol. 2011;95(11):156 4-7. doi: 10.1136/bjo.2010.195826.
59) Ryan EH Jr, Gilbert HD. Results of surgical treatment of recent-onset full-thickness idiopathic macular holes. Arch Ophthalmol. 1994 Dec;112(12) :1545-53. doi: 10.1001/archopht.1994.01090240051025.
60) Banker AS, Freeman WR, Kim JW, et al. Vision-threatening complications of surgery for full-thickness macular holes. Vitrectomy for Macular Hole Study Group. Ophthalmology. 1997;104 (9):1442-53. doi: 10.1016/s0161-6420(97)30118-3.
61) Park SS, Marcus DM, Duker JS, et al. Posterior segment complications after vitrectomy for macular hole. Ophthalmology. 1995;102(5):775-81 . doi: 10.1016/s0161-6420(95)30956-6.
62) Lee SH, Park KH, Kim JH, et al. Secondary macular hole formation after vitrectomy. Reina. 2010;30(7):1072-7. doi: 10.1097/IAE.0b013e3181cd4819.
63) Smiddy WE. Macular hole formation without vitreofoveal traction. Arch Ophthalmol. 2008;126 (5):737-8. doi: 10.1001/archopht.126.5.737.
64) Lipham WJ, Smiddy WE. Idiopathic macular hole following vitrectomy: implications for pathogenesis. Ophthalmic Surg Lasers. 1997;28(8):633-9.
65) Wong M, Halpern RL, Frank JH. Traumatic reopening of macular hole following successful surgical repair. Int Med Case Rep J. 2017;10:69-71. doi: 10.2147/IMCRJ.S129253.
66) Komi Y, Katsumoto T, Yoshikawa Y, et al. Case of Spontaneous Closure and Recurrence of Macular Hole in Vitrectomized Eye. Int Med Case Rep J. 2023;16:641-645. doi: 10.2147/IMCRJ.S429577.
67) Shaikh S, Garretson B. Spontaneous closure of a recurrent macular hole following vitrecomy corroborated by optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2003;34(2):172-174. doi:10.3928/1542-8877-20030301-18.
68) Lo WR, Hubbard GB. Macular hole formation, spontaneous closure, and recurrence in a previously vitrectomized eye. Am J Ophthalmol. 2006;141(5): 962-964. doi: 10.1016/j.ajo.2005.12.012.
69) Akahori T, Iwase T, Yamamoto K, et al. Macular displacement after vitrectomy in eyes with idiopathic macular hole determined by optical coherence tomography angiography. Am J Ophthalmol. 2018; 189:111-121. doi: 10.1016/j.ajo.2018.02.021.
70) Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis. Ophthalmology. 2010;117(9):1815-1824. doi: 10.1016/j.ophtha.2010.01.017.
71) Kim YJ, Jo J, Lee JY, et al. Macular capillary plexuses after macular hole surgery: an optical coherence tomography angiography study. Br J Ophthalmol. 2018;102(7):966-970. doi: 10.1136/ bjophthalmol-2017-311132.
72) Demirel S, Değirmenci MFK, Bilici S, et al. The recovery of microvascular status evaluated by optical coherence tomography angiography in patients after successful macular hole surgery. Ophthalmic Res. 2018;59(1):53-57. doi: 10.1159/000484092.
73) Cheng D, Tao JW, Yu XT, et al. Characteristics of macular microvasculature before and after idiopathic macular hole surgery. Int J Ophthalmol. 2022;15(1):98-105. doi: 10.18240/ijo.2022.01.15.
74) Li J, Wang W, Zhang X, et al. Morphological and Functional Features in Patients with Idiopathic Macular Hole Treatment. Int J Gen Med. 2022 Apr 28; 15:4505-4511. doi: 10.2147/IJGM.S365886.
75) Scupola A, Mastrocola A, Sasso P, et al. Assessment of retinal function before and after idiopathic macular hole surgery. Am J Ophthalmol. 2013;156(1):132-139.e1. doi: 10.1016/j.ajo.2013.02.007.
76) Hashimoto Y, Saito W, Fujiya A, et al. Changes in inner and outer retinal layer thicknesses after vitrectomy for idiopathic macular hole: implications for visual prognosis. PLoS One. 2015;10(8): e013 5925. doi: 10.1371/journal.pone.0135925.
77) Tsukahara S, Takeyama A, Ishida M. Retinal displacement using optical coherence tomography angiography and metamorphopsia in eyes undergoing macular hole surgery. Jpn J Ophthalmol. 2025;69( 3):395-402. doi: 10.1007/s10384-025-01176-5.
78) Shekhawat N, Karra A, Gupta E, et al. A cross-sectional study of macular displacement after macular hole surgery with ILM peeling in patients with idiopathic macular hole. Indian J Ophthalmol. 2024;72: S140-S143. doi: 10.4103/IJO.IJO_2707_22.
79) Kawano K, Ito Y, Kondo M, et al. Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling. Eye (Lond). 2013 Jul;27(7):871-877. doi: 10.1038/ eye.2013.99.
80) Ishida M, Ichikawa Y, Higashida R, et al. Retinal displacement toward optic disc after internal limiting membrane peeling for idiopathic macular hole. Am J Ophthalmol. 2014;157(5):971-977. doi: 10.1016/j.ajo.2014.01.026.
2) Cicinelli MV, Marchese A, Bandello F, e al. Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography. J Ophthalmol. 2019; 2019:3821479. doi: 10.1155/2019/3821479.
3) Singh S, Saxena S, Meyer CH, e al. Retinal photoreceptor ellipsoid zone is a structural biomarker for visual outcome after successful macular hole surgery: A novel grading system-based study. Indian J Ophthalmol. 2025;73(Suppl 1):S126-S131. doi: 10.4103/IJO.IJO_1031_24.
4) Baba T, Yamamoto S, Arai M, et al. Correlation of visual recovery and presence of photoreceptor inner/outer segment junction in optical coherence images after successful macular hole repair. Retina. 2008;28(3):453-8. doi: 10.1097/IAE.0b013e3181571398.
5) Saxena S, Ruia S, Prasad S, et al. Increased serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor external limiting membrane and inner segment ellipsoid zone in type 2 diabetes mellitus. Retina. 2017;37 (2):344-349. doi: 10.1097/IAE.0000000000001163.
6) Jain A, Saxena S, Khanna VK, et al. Status of serum VEGF and ICAM-1 and its association with external limiting membrane and inner segment-outer segment junction disruption in type 2 diabetes mellitus. Mol Vis 2013; 19:1760–8. http://www.molvis.org/molvis/v19/1760 .
7) Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: Spectral-domain optical coherence tomographic analysis. Ophthalmology. 2010;117:1 815-24. doi: 10.1016/j.ophtha.2010.01.017.
8) Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Schuman JS, Swanson EA, Fujimoto JG. Optical coherence tomography of macular holes. Ophthalmology. 1995 May;102(5):748-56. doi: 10.1016/s0161-6420 (95)30959-1. PMID: 7777274.
9) Sano M, Shimoda Y, Hashimoto H, Kishi S. Restored photoreceptor outer segment and visual recovery after macular hole closure. Am J Ophthalmol. 2009;147(2):313-318.e1. doi: 10.1016 /j.ajo.2008.08.002.
10) Mansour AM, Parodi M, Uwaydat SH, et al. Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review. J Ophthalmic Vis Res. 2023;18(4):424-432. doi: 10.18502/jovr. v18i4.14555.
11) Mahmoud TH, McCuen BW 2nd. Natural history of foveolar lucencies observed by optical coherence tomography after macular hole surgery. Retina. 2007;27(1):95-100. doi: 10.1097/01.iae.000 0223758.17543.49.
12) Oh J, Smiddy WE, Flynn HW Jr, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery. Invest Ophthalmol Vis Sci. 2010;51(3) :1651-8. doi: 10.1167/iovs.09-4420.
13) Goldberg JL, Klassen MP, Hua Y, et al. Amacrine-signaled loss of intrinsic axon growth ability by retinal ganglion cells. Science. 2002;296 (5574):1860-4. doi: 10.1126/science.1068428.
14) Shewan D, Berry M, Cohen J. Extensive regeneration in vitro by early embryonic neurons on immature and adult CNS tissue. J Neurosci. 1995;15(3 Pt 1):2057-62. doi: 10.1523/JNEUROSCI .15-03-02057.1995.
15) Li D, Field PM, Raisman G. Failure of axon regeneration in postnatal rat entorhinohippocampal slice coculture is due to maturation of the axon, not that of the pathway or target. Eur J Neurosci. 1995;7(6):1164-71. doi: 10.1111/j.1460-9568. 1995 .tb01106. x.
16) Celsi F, Pizzo P, Brini M, et al. Mitochondria, calcium and cell death: a deadly triad in neurodegeneration. Biochim Biophys Acta. 2009; 1787:335–344. doi: 10.1016/j.bbabio.2009.02.021.
17) Kim Y, Kim ES, Yu SY, et al. Age-related clinical outcome after macular hole surgery. Retina. 2017; 37(1):80-87. doi: 10.1097/IAE.0000000000001162.
18) Chinnery HR, McLenachan S, Humphries T, et al. Accumu lation of murine subretinal macrophages: effects of age, pigmentation and CX3CR1. Neurobiol Aging. 2012;33(8):1769-76. doi: 10.1016/j.neurobi olaging.2011.03.010.
19) Cornish K, Lois N, Scott N, et al. Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH). Cochrane Database Syst Rev. 2013;(6):CD009306. doi: 10.10 02/14651858.CD009306.pub2.
20) Brooks HL Jr. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology. 2000;107(10):1939-48; discussion 1948-9. doi: 10.1016/s0161-6420(00)00331-6.
21) Yoshida M, Kishi S. Pathogenesis of macular hole recurrence and its prevention by internal limiting membrane peeling. Retina. 2007;27(2):169 -73. doi: 10.1097/01.iae.0000224940. 79223.fb.
22) Simon GJ, Desatnik H, Alhalel A, et al. Retrospective analysis of vitrectomy with and without internal limiting membrane peeling for stage 3 and 4 macular hole. Ophthalmic Surg Lasers Imaging. 2004;35(2):109-15. PMID: 15088820.
23) Haritoglou C, Reiniger IW, Schaumberger M, et al. Five-year follow-up of macular hole surgery with peeling of the internal limiting membrane: update of a prospective study. Retina. 2006; 26(6): 618-22. doi: 10.1097/01.iae.0000236474.63819.3a.
24) Christensen UC. Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology. Acta Ophthalmol. 2009; 87 Thesis 2:1-23. doi: 10.1111/j.1755-3768.2009.01777. x.
25) Baba T, Sato E, Oshitari T, Yamamoto S. Regional reduction of ganglion cell complex after vitrectomy with internal limiting membrane peeling for idiopathic macular hole. J Ophthalmol. 2014; 2014:372589. doi: 10.1155/2014/372589.
26) Sabater AL, Velázquez-Villoria Á, Zapata MA, et al. Evaluation of macular retinal ganglion cell-inner plexiform layer thickness after vitrectomy with internal limiting membrane peeling for idiopathic macular holes. Biomed Res Int. 2014; 2014:45863 1. doi: 10.1155/2014/458631.
27) Clark A, Balducci N, Pichi F, et al. Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling. Retina. 2012;32(8):1608-13. doi: 10.1097/IAE.0b013e3182437e86.
28) Balducci N, Morara M, Veronese C, et al. Retinal nerve fiber layer thickness modification after internal limiting membrane peeling. Retina. 2014; 34(4):655-63. doi: 10.1097/IAE.0000000000000004
29) Kumagai K, Ogino N, Furukawa M, et al. Retinal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane. Clin Ophthalmol. 2012; 6:679-88. doi: 10.2147/OPTH.S30288.
30) Ye X, Xu J, He S, et al. Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery. Eye (Lond). 2023;37(7):1451-1457. doi: 10.1038/s4143 3-022-02150-y.
31) He S, Ye X, Qiu W, et al. Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study. J Pers Med. 2023; 13(2):255. doi: 10.3390/jpm13020255.
32) Sabry D, El-Kannishy A, Kamel R, et al. Correlation between en face optical coherence tomography defects of the inner retinal layers and ganglion cell inner plexiform layer analysis after internal limiting membrane peeling for idiopathic full-thickness macular hole. Invest Ophthalmol Vis Sci. 2016;57(9):444-50. doi: 10.1167/iovs.15-18043.
33) Ito Y, Terasaki H, Takahashi A. Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes. Ophthalmology. 2005; 112(8):1415-20. doi: 10.1016/j.ophtha.2005.02.023.
34) Takai Y, Tanito M, Sugihara K, et al. Temporal inverted internal limiting membrane flap technique for a macular hole patient unable to maintain postoperative prone positioning. Retin Cases Brief Rep. 2016:10(4):323-6. doi: 10.1097/ICB.0000000 000000258.
35) Michalewska Z, Michalewski J, Nawrocki J, et al. Temporal inverted internal limiting membrane flap technique versus classic inverted internal limiting membrane flap technique: a comparative study. Retina. 2015; 35(9):1844-50. doi: 10.1097/ IAE.0000000000000555.
36) Hirata A, Mine K, Hayashi K. Contractility of temporal inverted internal limiting membrane flap after vitrectomy for macular hole. Sci Rep. 2021 ;11(1):20035. doi: 10.1038/s41598-021-99509-0.
37) Sakimoto S, Ikuno Y, Fujimoto S, et al. Characteristics of the retinal surface after internal limiting membrane peeling in highly myopic eyes. Am J Ophthalmol. 2014;158(4):762-768.e1. doi: 10.1016/j.ajo.2014.06.024.
38) Kim KY, Yu SY, Kim M, et al. Morphological change of inner retinal layer on spectral-domain optical coherence tomography following macular hole surgery. Ophthalmologica. 2013;230(1):18-26. doi: 10.1159/000350552.
39) Steel DH, Dinah C, Habib M, et al. ILM peeling technique influences the degree of a dissociated optic nerve fiber layer appearance after macular hole surgery. Graefes Arch Clin Exp Ophthalmol. 2015;253(5):691-8. doi: 10.1007/s00417-014-2734-z.
40) Nukada K, Hangai M, Ooto S, et al. Tomographic features of macula after successful macular hole surgery. Invest Ophthalmol Vis Sci. 2013;54(4):2417-28. doi: 10.1167/iovs.12-10838.
41) Spaide RF. "Dissociated optic nerve fiber layer appearance" after internal limiting membrane removal is inner retinal dimpling. Retina. 2012;32 (9):1719-26. doi: 10.1097/IAE.0b013e3182671191.
42) Ikeda T, Nakamura K, Sato T, et al. Involvement of anoikis in dissociated optic nerve fiber layer appearance. Int J Mol Sci. 2021;22(4):1724. doi: 10.3390/ijms22041724.
43) Kim YH, Song MS, Togloom A, et al. Bidirectional dimples after internal limiting membrane peeling for a macular hole. Transl Vis Sci Technol. 2023;12(5):23. doi: 10.1167/tvst.12.5.23.
44) Steel DH, Dinah C, White K, et al. The relationship between a dissociated optic nerve fibre layer appearance after macular hole surgery and Muller cell debris on peeled internal limiting membrane. Acta Ophthalmol. 2017;95(2):153-157. doi: 10.1111/aos.13195.
45) Tao J, Yang J, Wu Y, et al. Internal limiting membrane peeling distorts the retinal layers and induces scotoma formation in the perifoveal temporal macula. Retina. 2022;42(12):2276-2283. doi: 10.1097/IAE.0000000000003619.
46) Balducci N, Morara M, Veronese C, et al. Retinal nerve fiber layer thickness modification after internal limiting membrane peeling. Retina 2014; 34(4):655-63. doi: 10.1097/IAE.0000000000000004.
47) Modi A, Giridhar A, Gopalakrishnan M. Spectral domain optical coherence tomography–based microstructural analysis of retinal architecture post internal limiting membrane peeling for surgery of idiopathic macular hole repair. Retina. 2017;37(2):291-298. doi: 10.1097/ IAE.0000000000001129.
48) Farah ME, Maia M, Rodrigues EB. Dyes in ocular surgery: principles for use in chromovitrectomy. Am J Ophthalmol. 2009;148(3):332-40. doi: 10.10 16/j.ajo.2009.04.003.
49) Piccirillo V, Sbordone S, Sorgente F, et al. Evaluation of efficacy and safety of new high-density dyes for chromovitrectomy. Sci Rep. 2021; 11(1):15171. doi: 10.1038/s41598-021-94770-9.
50) Takamura Y, Tomomatsu T, Matsumura T, et al. Correlation between central retinal thickness after successful macular hole surgery and visual outcome. Jpn J Ophthalmol. 2015;59(6):394-400. doi: 10.1007/s10384-015-0406-0.
51) Wollensak G, Spoerl E, Grosse G, et al. Biomechanical significance of the human internal limiting lamina. Retina. 2006;26(8):965-8. doi: 10.1097/01.iae.0000250001.45661.95.
52) Hogan MJ, Alvarado JA, Weddell JE. Histology of the Human Eye.An atlas and textbook Philadelphia: WB Saunders Company. (1971), 523–606. DOI:10. 1001/jama.1972.03190280059024 Corpus ID: 72719454
53) Goto K, Iwase T, Akahori T, et al. Choroidal and retinal displacements after vitrectomy with internal limiting membrane peeling in eyes with idiopathic macular hole. Sci Rep. 2019;9(1):17568. doi: 10.1038/s41598-019-54106-0.
54) Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003;87(8):1015-9. doi: 10.1136/bjo.87.8.1015.
55) Imai M, Iijima H, Gotoh T, et al. Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol. 1999;128(5):621-7. doi: 10.1016/s0002-9394(99)00200-7.
56) Tornambe PE, Poliner LS, Cohen RG. Definition of macular hole surgery end points: elevated/open, flat/open, flat/closed. Retina. 1998;18(3):286-7. doi: 10.1097/00006982-199803000-00021.
57) Hillenkamp J, Kraus J, Framme C, et al. Retreatment of full-thickness macular hole: predictive value of optical coherence tomography. Br J Ophthalmol. 2007;91(11):1445-9. doi: 10.1136/bjo.2007.115642.
58) D'Souza MJ, Chaudhary V, Devenyi R, et al. Re-operation of idiopathic full-thickness macular holes after initial surgery with internal limiting membrane peel. Br J Ophthalmol. 2011;95(11):156 4-7. doi: 10.1136/bjo.2010.195826.
59) Ryan EH Jr, Gilbert HD. Results of surgical treatment of recent-onset full-thickness idiopathic macular holes. Arch Ophthalmol. 1994 Dec;112(12) :1545-53. doi: 10.1001/archopht.1994.01090240051025.
60) Banker AS, Freeman WR, Kim JW, et al. Vision-threatening complications of surgery for full-thickness macular holes. Vitrectomy for Macular Hole Study Group. Ophthalmology. 1997;104 (9):1442-53. doi: 10.1016/s0161-6420(97)30118-3.
61) Park SS, Marcus DM, Duker JS, et al. Posterior segment complications after vitrectomy for macular hole. Ophthalmology. 1995;102(5):775-81 . doi: 10.1016/s0161-6420(95)30956-6.
62) Lee SH, Park KH, Kim JH, et al. Secondary macular hole formation after vitrectomy. Reina. 2010;30(7):1072-7. doi: 10.1097/IAE.0b013e3181cd4819.
63) Smiddy WE. Macular hole formation without vitreofoveal traction. Arch Ophthalmol. 2008;126 (5):737-8. doi: 10.1001/archopht.126.5.737.
64) Lipham WJ, Smiddy WE. Idiopathic macular hole following vitrectomy: implications for pathogenesis. Ophthalmic Surg Lasers. 1997;28(8):633-9.
65) Wong M, Halpern RL, Frank JH. Traumatic reopening of macular hole following successful surgical repair. Int Med Case Rep J. 2017;10:69-71. doi: 10.2147/IMCRJ.S129253.
66) Komi Y, Katsumoto T, Yoshikawa Y, et al. Case of Spontaneous Closure and Recurrence of Macular Hole in Vitrectomized Eye. Int Med Case Rep J. 2023;16:641-645. doi: 10.2147/IMCRJ.S429577.
67) Shaikh S, Garretson B. Spontaneous closure of a recurrent macular hole following vitrecomy corroborated by optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2003;34(2):172-174. doi:10.3928/1542-8877-20030301-18.
68) Lo WR, Hubbard GB. Macular hole formation, spontaneous closure, and recurrence in a previously vitrectomized eye. Am J Ophthalmol. 2006;141(5): 962-964. doi: 10.1016/j.ajo.2005.12.012.
69) Akahori T, Iwase T, Yamamoto K, et al. Macular displacement after vitrectomy in eyes with idiopathic macular hole determined by optical coherence tomography angiography. Am J Ophthalmol. 2018; 189:111-121. doi: 10.1016/j.ajo.2018.02.021.
70) Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis. Ophthalmology. 2010;117(9):1815-1824. doi: 10.1016/j.ophtha.2010.01.017.
71) Kim YJ, Jo J, Lee JY, et al. Macular capillary plexuses after macular hole surgery: an optical coherence tomography angiography study. Br J Ophthalmol. 2018;102(7):966-970. doi: 10.1136/ bjophthalmol-2017-311132.
72) Demirel S, Değirmenci MFK, Bilici S, et al. The recovery of microvascular status evaluated by optical coherence tomography angiography in patients after successful macular hole surgery. Ophthalmic Res. 2018;59(1):53-57. doi: 10.1159/000484092.
73) Cheng D, Tao JW, Yu XT, et al. Characteristics of macular microvasculature before and after idiopathic macular hole surgery. Int J Ophthalmol. 2022;15(1):98-105. doi: 10.18240/ijo.2022.01.15.
74) Li J, Wang W, Zhang X, et al. Morphological and Functional Features in Patients with Idiopathic Macular Hole Treatment. Int J Gen Med. 2022 Apr 28; 15:4505-4511. doi: 10.2147/IJGM.S365886.
75) Scupola A, Mastrocola A, Sasso P, et al. Assessment of retinal function before and after idiopathic macular hole surgery. Am J Ophthalmol. 2013;156(1):132-139.e1. doi: 10.1016/j.ajo.2013.02.007.
76) Hashimoto Y, Saito W, Fujiya A, et al. Changes in inner and outer retinal layer thicknesses after vitrectomy for idiopathic macular hole: implications for visual prognosis. PLoS One. 2015;10(8): e013 5925. doi: 10.1371/journal.pone.0135925.
77) Tsukahara S, Takeyama A, Ishida M. Retinal displacement using optical coherence tomography angiography and metamorphopsia in eyes undergoing macular hole surgery. Jpn J Ophthalmol. 2025;69( 3):395-402. doi: 10.1007/s10384-025-01176-5.
78) Shekhawat N, Karra A, Gupta E, et al. A cross-sectional study of macular displacement after macular hole surgery with ILM peeling in patients with idiopathic macular hole. Indian J Ophthalmol. 2024;72: S140-S143. doi: 10.4103/IJO.IJO_2707_22.
79) Kawano K, Ito Y, Kondo M, et al. Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling. Eye (Lond). 2013 Jul;27(7):871-877. doi: 10.1038/ eye.2013.99.
80) Ishida M, Ichikawa Y, Higashida R, et al. Retinal displacement toward optic disc after internal limiting membrane peeling for idiopathic macular hole. Am J Ophthalmol. 2014;157(5):971-977. doi: 10.1016/j.ajo.2014.01.026.