Microperimetric Determination of Retinal Sensitivity in Areas of Dissociated Optic Nerve Fiber Layer Following Internal Limiting Membrane Peeling

Purpose: To investigate the effects of a dissociated optic nerve fiber layer (DONFL) on retinal sensitivity. Methods: The medical records of 17 eyes with an idiopathic macular hole that underwent vitrectomy and internal limiting membrane (ILM) peeling were examined. All patients underwent a complete ophthalmic examination, color fundus photography, and argon blue-filter photography to determine whether a DONFL was present. The retinal function was assessed by comparing the mean retinal sensitivities in the DONFL area to those in the surrounding normal retina by static microperimetry >3 months after the surgery. The retinal sensitivities of eight regions nearest the fovea and all at the same distance from it were determined in all patients. We divided the retinal sensitivities in the two areas, that is, inside and outside the area of the DONFL, and compared each mean value. Results: Following the initial vitrectomy, the macular holes of all eyes were closed. The mean retinal sensitivities in the area of the DONFL did not differ significantly from those in the surrounding areas (P = 0.60). Conclusions: DONFL associated with ILM peeling does not alter retinal function in the area of the DONFL as it does with a nerve fiber layer defect. Jpn J Ophthalmol 2010;54:435-440 (C) Japanese Ophthalmological Society 2010