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Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique

The appropriate surgical technique to improve the closure rate of perioperative full-thickness macular hole (FTMH) secondary to submacular hemorrhage (SMH) with sub-internal limiting membrane (ILM) hemorrhage caused by retinal arterial macroaneurysm (RAM) rupture remains an unsolved clinical problem...

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Autores principales: Kimura, Akari, Imai, Hisanori, Iwane, Yukako, Kishimoto, Maya, Sotani, Yasuyuki, Yamada, Hiroko, Matsumiya, Wataru, Miki, Akiko, Kusuhara, Sentaro, Nakamura, Makoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179198/
https://www.ncbi.nlm.nih.gov/pubmed/37176731
http://dx.doi.org/10.3390/jcm12093291
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author Kimura, Akari
Imai, Hisanori
Iwane, Yukako
Kishimoto, Maya
Sotani, Yasuyuki
Yamada, Hiroko
Matsumiya, Wataru
Miki, Akiko
Kusuhara, Sentaro
Nakamura, Makoto
author_facet Kimura, Akari
Imai, Hisanori
Iwane, Yukako
Kishimoto, Maya
Sotani, Yasuyuki
Yamada, Hiroko
Matsumiya, Wataru
Miki, Akiko
Kusuhara, Sentaro
Nakamura, Makoto
author_sort Kimura, Akari
collection PubMed
description The appropriate surgical technique to improve the closure rate of perioperative full-thickness macular hole (FTMH) secondary to submacular hemorrhage (SMH) with sub-internal limiting membrane (ILM) hemorrhage caused by retinal arterial macroaneurysm (RAM) rupture remains an unsolved clinical problem. Several ILM transplantation techniques have been attempted, but these are challenging. Our new technique can remove sub-ILM hemorrhage with the central fovea ILM intact, without peeling the ILM. The medical records of three eyes from three patients with SMH and sub-ILM hemorrhage secondary to RAM rupture were retrospectively reviewed. During the surgery, a small ILM fissure was made outside the central fovea with ILM forceps, and sub-ILM hemorrhage was washed out through it by manually spraying balanced salt solution. Sub-ILM hemorrhage removal was achieved successfully in all eyes, with no occurrences of FTMH or other complications. Best-corrected decimal visual acuity improved from 0.05 (Snellen equivalent (SE), 20/400), 0.05 (SE, 20/400), and 0.05 (SE, 20/400) preoperatively to 0.3 (SE, 20/63), 0.4 (SE, 20/50), and 0.15 (SE, 20/125) at 3 months postoperatively, respectively. This new technique may help keep the foveal ILM intact and prevent perioperative FTMH formation.
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spelling pubmed-101791982023-05-13 Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique Kimura, Akari Imai, Hisanori Iwane, Yukako Kishimoto, Maya Sotani, Yasuyuki Yamada, Hiroko Matsumiya, Wataru Miki, Akiko Kusuhara, Sentaro Nakamura, Makoto J Clin Med Brief Report The appropriate surgical technique to improve the closure rate of perioperative full-thickness macular hole (FTMH) secondary to submacular hemorrhage (SMH) with sub-internal limiting membrane (ILM) hemorrhage caused by retinal arterial macroaneurysm (RAM) rupture remains an unsolved clinical problem. Several ILM transplantation techniques have been attempted, but these are challenging. Our new technique can remove sub-ILM hemorrhage with the central fovea ILM intact, without peeling the ILM. The medical records of three eyes from three patients with SMH and sub-ILM hemorrhage secondary to RAM rupture were retrospectively reviewed. During the surgery, a small ILM fissure was made outside the central fovea with ILM forceps, and sub-ILM hemorrhage was washed out through it by manually spraying balanced salt solution. Sub-ILM hemorrhage removal was achieved successfully in all eyes, with no occurrences of FTMH or other complications. Best-corrected decimal visual acuity improved from 0.05 (Snellen equivalent (SE), 20/400), 0.05 (SE, 20/400), and 0.05 (SE, 20/400) preoperatively to 0.3 (SE, 20/63), 0.4 (SE, 20/50), and 0.15 (SE, 20/125) at 3 months postoperatively, respectively. This new technique may help keep the foveal ILM intact and prevent perioperative FTMH formation. MDPI 2023-05-05 /pmc/articles/PMC10179198/ /pubmed/37176731 http://dx.doi.org/10.3390/jcm12093291 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Kimura, Akari
Imai, Hisanori
Iwane, Yukako
Kishimoto, Maya
Sotani, Yasuyuki
Yamada, Hiroko
Matsumiya, Wataru
Miki, Akiko
Kusuhara, Sentaro
Nakamura, Makoto
Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title_full Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title_fullStr Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title_full_unstemmed Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title_short Removal of Sub-Internal Limiting Membrane Hemorrhage Secondary to Retinal Arterial Macroaneurysm Rupture: Internal Limiting Membrane Non-Peeling Technique
title_sort removal of sub-internal limiting membrane hemorrhage secondary to retinal arterial macroaneurysm rupture: internal limiting membrane non-peeling technique
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179198/
https://www.ncbi.nlm.nih.gov/pubmed/37176731
http://dx.doi.org/10.3390/jcm12093291
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