Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

Kase, Satoru; Saito, Wataru; Mori, Shohei; Saito, Michiyuki; Ando, Ryo; Dong, Zhenyu; Suzuki, Tomohiro; Noda, Kousuke; Ishida, Susumu

Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

Kase, Satoru; Saito, Wataru; Mori, Shohei et al.

Clinical ophthalmology, 2017, 11, 9-14

Permalink : https://hdl.handle.net/2115/64553

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アクセス権	open access
URI	https://hdl.handle.net/2115/64553
タイトル	Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique
著者	Kase, Satoru ; Saito, Wataru ; Mori, Shohei ; Saito, Michiyuki ; Ando, Ryo ; Dong, Zhenyu ; Suzuki, Tomohiro ; Noda, Kousuke ; Ishida, Susumu
e-Rad_Researcher 60374394 著者名 Kase, Satoru
e-Rad_Researcher 00339160 著者名 Saito, Wataru
著者名 Mori, Shohei
著者名 Saito, Michiyuki
著者名 Ando, Ryo
著者名 Dong, Zhenyu
著者名 Suzuki, Tomohiro
e-Rad_Researcher 90296666 著者名 Noda, Kousuke
e-Rad_Researcher 10245558 著者名 Ishida, Susumu
言語	英語
キーワード	inverted ILM flap
	glial cells
	OCT
	macular hole
	histopathology
発行日	2017
出版者	Dove Medical Press
収録物名	Clinical ophthalmology
巻(号)	11
ページ	9-14
抄録	Purpose: The aims of this study were to analyze optical coherence tomography (OCT) imaging of large macular holes (MHs) treated with inverted internal limiting membrane (ILM) flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy. Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV) with inverted ILM flap technique assisted by brilliant blue G (BBG) staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP). Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%). Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration. Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 3.0 Unported
PISSN	1177-5483
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.2147/OPTH.S119762