{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:12:51Z","timestamp":1773299571701,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Science and Technology Project of Zhejiang Province","award":["2023KY915"],"award-info":[{"award-number":["2023KY915"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Purpose: This study aimed to evaluate morphological changes of the retina in eyes with dissociated optic nerve fiber layer (DONFL) appearance following internal limiting membrane (ILM) peeling for full-thickness idiopathic macular hole (IMH) on spectral-domain optical coherence tomography (SD-OCT). (2) Methods: We retrospectively analyzed 39 eyes of 39 patients with type 1 macular hole closure after a vitrectomy with ILM peeling procedure at a six-month minimum postoperative follow-up. The retinal thickness maps and cross-sectional OCT images were obtained from a clinical OCT device. The cross-sectional area of the retinal nerve fiber layer (RNFL) on cross-sectional OCT images was manually measured by ImageJ software. (3) Results: The inner retinal layers (IRLs) thickness thinned down much more in the temporal quadrant than in nasal quadrants at 2 and 6 months postoperatively (p &lt; 0.001). However, the cross-sectional area of the RNFL did not change significantly at 2 and 6 months postoperatively (p &gt; 0.05) when compared to preoperative data. In addition, the thinning of the IRL did not correlate with the best-corrected visual acuity (BCVA) at 6 months postoperatively. (4) Conclusions: The thickness of the IRL decreased in eyes with a DONFL appearance after ILM peeling for IMH. The thickness of the IRL decreased more in the temporal retina than in the nasal retina, but the change did not affect BCVA during the 6 months after surgery.<\/jats:p>","DOI":"10.3390\/jpm13020255","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T04:58:25Z","timestamp":1675054705000},"page":"255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Shucheng","family":"He","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Ye","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangli","family":"Qiu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shangchao","family":"Yang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaxing","family":"Zhong","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiqi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zhejiang Provincial People\u2019s Hospital, Hangzhou 310014, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"He","sequence":"additional","affiliation":[{"name":"Computer Science & Software School, Hangzhou Dianzi University, Hangzhou 310018, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Shen","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"},{"name":"Department of Ophthalmology, Zhejiang Provincial People\u2019s Hospital, Hangzhou 310014, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1001\/archopht.1988.01060130683026","article-title":"Idiopathic senile macular hole. Its early stages and pathogenesis","volume":"106","author":"Gass","year":"1988","journal-title":"Arch. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.survophthal.2022.03.007","article-title":"An evidence-based review of the epidemiology of myopic traction maculopathy","volume":"67","author":"Cheong","year":"2022","journal-title":"Surv. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1001\/archopht.117.6.821","article-title":"M\u00fcller cell cone, an overlooked part of the anatomy of the fovea centralis: Hypotheses concerning its role in the pathogenesis of macular hole and foveomacualr retinoschisis","volume":"117","author":"Gass","year":"1999","journal-title":"Arch. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3467381","DOI":"10.1155\/2019\/3467381","article-title":"Pathogenesis and Management of Macular Hole: Review of Current Advances","volume":"2019","author":"Bikbova","year":"2019","journal-title":"J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100977","DOI":"10.1016\/j.preteyeres.2021.100977","article-title":"M\u00fcller cells and astrocytes in tractional macular disorders","volume":"86","author":"Bringmann","year":"2022","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/S0161-6420(93)31419-3","article-title":"Vitreous surgery for macular holes","volume":"100","author":"Wendel","year":"1993","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1097\/IAE.0000000000003394","article-title":"Efficacy of air tamponade treatment of idiopathic macular holes of different diameters and of follow-up intravitreal air tamponade for persistent holes","volume":"42","author":"Tao","year":"2022","journal-title":"Retina"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1016\/S0161-6420(01)00856-9","article-title":"Dissociated optic nerve fiber layer appearance of the fundus after idiopathic epiretinal membrane removal","volume":"108","author":"Tadayoni","year":"2001","journal-title":"Ophthalmology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1167\/tvst.11.8.11","article-title":"In Vivo Imaging of Retinal and Choroidal Morphology and Vascular Plexuses of Vertebrates Using Swept-Source Optical Coherence Tomography","volume":"11","author":"Meleppat","year":"2022","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"066011","DOI":"10.1117\/1.JBO.24.6.066011","article-title":"Directional optical coherence tomography reveals melanin concentration-dependent scattering properties of retinal pigment epithelium","volume":"24","author":"Meleppat","year":"2019","journal-title":"J. Biomed. Opt."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"8349","DOI":"10.1167\/iovs.11-8043","article-title":"En face optical coherence tomography of inner retinal defects after internal limiting membrane peeling for idiopathic macular hole","volume":"52","author":"Alkabes","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.ophtha.2005.04.026","article-title":"Relationship of dissociated optic nerve fiber layer appearance to internal limiting membrane peeling","volume":"112","author":"Mitamura","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"317","DOI":"10.5301\/ejo.5001067","article-title":"Incidence and quantitative analysis of dissociated optic nerve fiber layer appearance: Real loss of retinal nerve fiber layer?","volume":"28","author":"Kim","year":"2018","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2417","DOI":"10.1167\/iovs.12-10838","article-title":"Tomographic features of macula after successful macular hole surgery","volume":"54","author":"Nukada","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"138","DOI":"10.4274\/tjo.34545","article-title":"Evaluation of Ganglion Cell-Inner Plexiform Layer Thickness after Vitreoretinal Surgery with Internal Limiting Membrane Peeling in Cases with Idiopathic Macular Hole","volume":"47","author":"Demirel","year":"2017","journal-title":"Turk. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1007\/s00417-012-2173-7","article-title":"Retinal thickness in eyes with idiopathic macular hole after vitrectomy with internal limiting membrane peeling","volume":"251","author":"Ohta","year":"2013","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1159\/000480243","article-title":"Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery","volume":"59","author":"Faria","year":"2018","journal-title":"Ophthalmic Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4624164","DOI":"10.1155\/2021\/4624164","article-title":"Long-Term Observations of Thickness Changes of Each Retinal Layer following Macular Hole Surgery","volume":"2021","author":"Tada","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.1097\/IAE.0000000000002017","article-title":"Factors associated with development of dissociated optic nerve fiber layer appearance in the pioneer intraoperative optical coherence tomography study","volume":"38","author":"Runkle","year":"2018","journal-title":"Retina"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1007\/s00417-020-04920-4","article-title":"Macular hole closure patterns: An updated classification","volume":"258","author":"Rossi","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2611","DOI":"10.1016\/j.ophtha.2013.07.042","article-title":"The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole","volume":"120","author":"Duker","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.ophtha.2005.02.023","article-title":"Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes","volume":"112","author":"Ito","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1136\/bjophthalmol-2019-315095","article-title":"Role of internal limiting membrane peeling in the prevention of epiretinal membrane formation following vitrectomy for retinal detachment: A randomised trial","volume":"104","author":"Kumar","year":"2020","journal-title":"Br. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ye, X., Xu, J., He, S., Wang, J., Yang, J., Tao, J., Chen, Y., and Shen, L. Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery. Eye, 2022.","DOI":"10.1038\/s41433-022-02150-y"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1097\/IAE.0b013e3182437e86","article-title":"Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling","volume":"32","author":"Clark","year":"2012","journal-title":"Retina"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1097\/IAE.0b013e3182671191","article-title":"\u201cDissociated optic nerve fiber layer appearance\u201d after internal limiting membrane removal is inner retinal dimpling","volume":"32","author":"Spaide","year":"2012","journal-title":"Retina"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2015.06.003","article-title":"Glia-neuron interactions in the mammalian retina","volume":"51","author":"Vecino","year":"2016","journal-title":"Prog Retin Eye Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ikeda, T., Nakamura, K., Sato, T., Kida, T., and Oku, H. (2021). Involvement of Anoikis in Dissociated Optic Nerve Fiber Layer Appearance. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22041724"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1002\/path.3000","article-title":"Anoikis: An emerging hallmark in health and diseases","volume":"226","author":"Taddei","year":"2012","journal-title":"J. Pathol."},{"key":"ref_30","first-page":"3466","article-title":"Immunolocalization of integrins in the human retina","volume":"35","author":"Brem","year":"1994","journal-title":"Investig. Ophthalmol Vis. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1167\/iovs.18-25257","article-title":"MMP Inhibition Preserves Integrin Ligation and FAK Activation to Induce Survival and Regeneration in RGCs Following Optic Nerve Damage","volume":"60","author":"Shabanzadeh","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"976","DOI":"10.4103\/0366-6999.179785","article-title":"Inhibition on Apoptosis Induced by Elevated Hydrostatic Pressure in Retinal Ganglion Cell-5 via Laminin Upregulating \u03b21-integrin\/Focal Adhesion Kinase\/Protein Kinase B Signaling Pathway","volume":"129","author":"Li","year":"2016","journal-title":"Chin. Med. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.stem.2022.01.002","article-title":"Cone photoreceptors in human stem cell-derived retinal organoids demonstrate intrinsic light responses that mimic those of primate fovea","volume":"29","author":"Saha","year":"2022","journal-title":"Cell Stem Cell"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1038\/cddis.2009.13","article-title":"BH3-only proteins BIM and PUMA in the regulation of survival and neuronal differentiation of newly generated cells in the adult mouse hippocampus","volume":"1","author":"Bunk","year":"2010","journal-title":"Cell Death Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.neuron.2011.08.014","article-title":"Life and death decision in adult neurogenesis: In praise of napping","volume":"71","author":"Lepousez","year":"2011","journal-title":"Neuron"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.mcn.2006.12.002","article-title":"E-cadherin promotes retinal ganglion cell neurite outgrowth in a protein tyrosine phosphatase-mu-dependent manner","volume":"34","author":"Oblander","year":"2007","journal-title":"Mol. Cell. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s10735-010-9307-1","article-title":"Expression of \u03b2A3\/A1-crystallin in the developing and adult rat eye","volume":"42","author":"Parthasarathy","year":"2011","journal-title":"J. Mol. Histol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/2\/255\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:19:33Z","timestamp":1760120373000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/2\/255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,30]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jpm13020255"],"URL":"https:\/\/doi.org\/10.3390\/jpm13020255","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,30]]}}}