Abstract
Purpose: :
To evaluate the effect of ICG-assisted Peeling of the Internal limiting membrane on visual acuity, retinal sensitivity and contrast sensitivity.
Methods: :
In a retrospective clinical case series, 13 consecutive ICG-assisted chromovitrectomy interventions in 13 patients with Macular pucker (N=5), Vitreomacular Traction syndrome (N=3), Persistent macular edema due to diabetes or retinal vein occlusion (N=3) or Macular hole stage III (N=2) were analyzed based on patient records. Best-corrected visual acuity (BCVA) based on ETDRS charts, contrast sensitivity using the Pelli-Robson Chart , mean retinal sensitivity (dB) and stability of fixation (Microperimetry, MP-1Nidek Technologies, Padova, Italy) and OCT had been measured pre- and postoperatively.
Results: :
Mean follow-up was 238 days ± 95. Most post-operative measures were improved compared to pre-operative values, including BCVA(0.73± 0.46 vs. 0.40 ± 0.33 log Mar, P=0.005), OCT (444µm ± 114 vs. 313µm ± 70; P=0.0069), contrast sensitivity (1.06 ± 0.53 vs. 1.21 ± 0.31, P = 0.21 ) and fixation stability (7 eyes classified as stable vs. 9 eyes classified as stable), while mean retinal sensitivity decreased from 11.4 ± 4.24dB to 9.01 ± 3.99dB (P= 0.012 ). Changes in retinal sensitivity were inadvertently subclinical.
Conclusions: :
Understanding of microperimetric response to ICG-assisted Chromovitrectomy is limited. Contrary to the relatively scarce body of evidence in the literature, our results show that retinal sensitivity may be negatively affected by ICG-assisted surgical removal of the ILM even if BCVA, OCT, contrast sensititvity and fixation stability improve. More research is needed to follow-up on the long term clinical significance of these subclinical scotomas.
Keywords: macula/fovea • macular holes • vitreoretinal surgery