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Shunsuke Tsuchiya, Tomomi Higashide, Kazuhisa Sugiyama; Visual field deterioration in central 10 degrees after vitrectomy for macular diseases in patients with glaucoma. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© 2017 Association for Research in Vision and Ophthalmology.
To investigate retinal sensitivity changes in the central 10 degrees after vitrectomy for epiretinal membrane (ERM) or macular hole (MH) in patients with glaucoma.
Seventy-one eyes of 71 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling for ERM or MH were included: glaucoma patients (G group), 29 eyes; non-glaucoma control group (C group), 42 eyes. The main outcome measure was postoperative visual field (VF) changes (5.3 ± 4.3 months after surgery) in standard automated perimetry (Humphrey visual field analyzer II, SITA standard 10-2 program). For each test point, ≥5 dB decrease in total deviation postoperatively was defined as deterioration in G group. For C group, test points with probability <1% on a pattern deviation map of postoperative VF were deemed as deterioration. We also evaluated best-corrected visual acuity (BCVA) and ganglion cell complex (GCC) thickness in the central 10 degrees by optical coherence tomography (RS-3000, NIDEK). VF and GCC thickness were analyzed in each sector; center, inner ring, and outer ring, defined by three concentric circles, 3.3°-, 10°- and 20°-diameters. Preoperative and postoperative factors related to the mean deviation (MD) changes were identified using univariate and multivariate linear regression analysis.
Postoperative MD was -9.4±6.7 dB in G group, and -1.1±1.1 dB in C group. Postoperative pattern standard deviation (PSD) was 8.7±5.0 dB in G group, and 1.4±0.6 dB in C group. In G group, postoperative MD and PSD were significantly deteriorated after surgery (P<0.01). The number of deteriorated test points was 12.2±8.3 in G group and 1.4±2.2 in C group. Fourteen out of 68 test points were deteriorated in >30% of 29 eyes in G group and were located in the nasal half of outer ring. In both groups, GCC thickness was significantly decreased after surgery (P<0.01), and its postoperative value of G group was significantly thinner than C group (P<0.01). BCVA was significantly improved after surgery in both groups (P<0.01). In G group, a multivariate regression analysis identified preoperative PSD as the associated factor for MD changes (β=-0.396, P=0.03).
In glaucomatous eyes with ERM or MH, retinal sensitivity in central 10 degrees, especially in the nasal half of outer ring, may deteriorate after vitrectomy with ILM peeling.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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