Fig. 5

Representative case of inverted Internal Limiting Membrane (ILM)-flap technique for large macular hole (LMH). Morphologic and functional changes over follow-up. OCT scans show the resolution of macular hole over follow-up (left column). Preoperative minimum macular hole diameter was 464 µm (left column, top panel). One month after surgery, the LMH was closed and the inverted ILM-flap could be seen covering the hole with a hyperreflective tissue inside the hole (left column, second row panel). Six months postoperatively, outer retinal layers were partially restored (left column, third row panel). Twelve months postoperatively, outer retinal layers were not completely restored (left column, bottom panel). Related microperimetric maps with Bivariate Contour Ellipse Area (BCEA) analysis over follow-up (right column). At baseline, microperimetry revealed an absolute scotoma (red/orange points with low sensitivity values) with a surrounding relative scotoma (yellow points) in the central degrees; BCEA (concentric ellipses) was large in diameter (right column, top panel). One month after surgery, both absolute and relative scotoma progressively reduced with a mild increase of whole sensitivity; BCEA showed a reduction in dimension (right column, second row panel). Six months postoperatively, all retinal sensitivity increased mainly on central degrees; BCEA had a mild increase in dimension (right column, third row panel). At last follow-up, we observed a mild reduction in central retinal sensitivity with a reduction of BCEA (right column, bottom panel)