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Mads Kofod, Morten de La Cour; Retinal Unfolding after Vitrectomi for Idiopathic Macular Pucker. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3315.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify retinal vessel movement following vitrectomy for idiopathic macular pucker. By measuring retinal vessel movement following removal of macular pucker we can describe how much and how fast the retina unfolds after vitrectomy.
Quantification of retinal vessel movement was measured by identification of retinal vessel branch points or features in aligned Spectralis OCT scanner infrared fundus images . The location of the same retinal vessel feature was analyzed before surgery, one month, three months, six months and 12 months following surgery. Patients included in this study were participating in a randomized clinical trial on early surgery of macular puckers. Retinal vessel movement in nine macular subfields was summed to an estimate of total retinal vessel movement called retinal tangential movement. Retinal thickness was measured by 20x20 degree OCT scans at each visit. Data is presented as mean and 95% confidence intervals.
The images of thirteen patients were analyzed in this study. Mean best corrected visual acuity measured on ETDRS charts was 76.2 (70.3-82.1) ETDRS letters before surgery. Following surgery it initially felt to 71 (63.8-78.2) ETDRS letters at one month post-surgery but increased to 76.4 (70.6-82.2) ETDRS at three months, 82.5 (78.7-86.4) ETDRS letters at six months and 81.3 (78.1-84.5) ETDRS letters at 12 months. Retinal tangential movement was 680 (495-865) µm after one month and increased to 734 (454-1014)µm after three months, 782 (529-1035)µm at six months and 885 (651-1119)µm after 12 months. These retinal tangential movements increased over time but no statistically significant correlation was shown. Retinal thickness reduced statistically significantly with time (p=0.010).
The study, despite its small size, found two common patterns following vitrectomy. One subgroup show fast unfolding of the retinal vessels within the first month following surgery. In these patients no significant retinal unfolding occurs after the first month. A second subset of patients showed slow unfolding with continued increased retinal tangential movement following surgery. A larger study is needed to successfully describe the difference between these groups and better estimate when the process of retinal vessel unfolding is complete.
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