Kh. P. Takhchidi, O. A. Ulasevich

Purpose:

Visual outcome of surgical treatment for IMH stages 3 and 4 is defined by IMH size and damage of underlying retinal layers. The question of surgical treatment reasonability for IMH stages 2 and, especially, stage 1 remains open. Our aim is to analyze the surgical treatment of initial stages of IMH with OCT.

Methods:

Patients with initial stages of IMH (9 eyes with stage 1 and 16 eyes with stage 2) underwent OCT of the macular region and the configuration of vitreous fixations to the fovea was defined. Subtotal vitrectomy was performed. Separation of the posterior hyaloid membrane was performed basing on OCT data. In cases of IMH stage 2 gas  mixed with air was injected into the vitreous cavity. In cases of pronounced radial folds of the internal limiting membrane around IMH stage 2 circular maculorhexis was
performed.

Results:

In the group with stage 1 IMH visual acuity has improved in 8 eyes, remained unchanged in 1 eye. In the group with IMH stage 2 visual acuity has improved in 14 eyes, remained stable in 1 and decreased in 1 due to cataract progression. In the group of IMH stage 1 normal profile of the fovea was achieved in all the eyes. In the group with IMH stage 2 normal profile of the fovea was achieved in 14 eyes, in 2 eyes smoothing of edges was seen.

Conclusion:

The tactics of surgical treatment for IMH initial stages is defined by the configuration of hyaloid fixation to the fovea on the basis of OCT data, which provides low surgical trauma and positive functional results.

Take-home message:

OCT provides a basis for tactic choice in surgical treatment for initial stages IMH.