June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
IS THE INTEGRITY OF THE PHOTORECEPTOR LAYER A PROGNOSTIC FACTOR FOR VISUAL ACUITY GAIN IN THICK MACULAR PUCKERS?
Author Affiliations & Notes
  • Aranzazu Mateo Montoya
    Retina, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
  • Benjamin Wolff
    Retina, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
  • Virginie Martinet
    Retina, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
  • Pierre-Loic Cornut
    Hôpital Edouard Herriot, Lyon, France
  • Jose Sahel
    Retina, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5859. doi:
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      Aranzazu Mateo Montoya, Benjamin Wolff, Virginie Martinet, Pierre-Loic Cornut, Jose Sahel; IS THE INTEGRITY OF THE PHOTORECEPTOR LAYER A PROGNOSTIC FACTOR FOR VISUAL ACUITY GAIN IN THICK MACULAR PUCKERS?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5859.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To determine whether surgery is worth it in cases of thick macular puckers with disrupted photoreceptor layer.

Methods: A retrospective analysis of 10 patients over a 6-month postoperative period was performed. Inclusion criterium was the presence of a macular pucker with a central foveal thickness (CFT) greater than 500 microns. The CFT, the integrity of the external limiting membrane (ELM), and the status of the inner segment/outer segment (IS/OS) junction layer on optical coherence tomography (OCT) were documented, both pre- and postoperatively. A 25-gauge 3-port pars plana vitrectomy was carried out in all patients. Filtered air was used as an internal tamponade in some patients. Patients were followed up at 24 hours, 1 week, and 1, 3 and 6 months postoperatively.

Results: Ten eyes (10 patients; 7 women and 3 men) were included. Patients were aged 52 to 70 years (mean: 62 years). The etiology of the macular pucker was primary in all cases, except for 3 patients in which it was secondary to a retinal detachment. Mean CFT was 747.4 microns preoperatively and 356.5 microns postoperatively. The ELM and the IS/OS junction layer were interrupted in all cases before the surgery, and continuous or with shorter gaps after surgery. Visual acuity (VA) improved from 1.20 ± 0.40 LogMAR preoperatively to 0.33 ± 0.35 at month 1, 0.25 ± 0.23 at month 3, and 0.18 ± 0.26 at month 6.

Conclusions: We obtained a significant VA improvement after thick macular pucker surgery. The absence of a continuous IS/OS junction layer on the OCT does not have a prognostic value in this kind of macular pucker.

Keywords: 585 macula/fovea • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 688 retina  
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