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Fabio Scarinci, Gaetano Cupo, Adele Chiaravalloti, Francesco Baccini, Riccardo Iervolino, Guido Ripandelli; Spectral Domain Optical Coherence Tomography and Microperimetry Outcomes after 23 Gauge Vitrectomy for Idiopathic Macular Pucker. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4484.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomical and functional outcomes after 23 gauge Pars Plana Vitrectomy (PPV) for macular pucker with high resolution Spectral Domain optical coherence tomography (HD-OCT) and microperimetry (MP1) after a short-term follow up.
Tirthy-eight eyes of 38 patients with macular pucker were enrolled. In all patients, ophthalmologic exams including best-corrected visual acuity (BCVA) using a Early Treatment of Diabetic Retinopathy Study chart, complete ophthalmic examination (including biomicroscopy of the fundus with a contact lens), Cirrus high definition (HD-OCT; Model 4000; Carl Zeiss, Dublin, California, USA) and microperimetry (MP1; Nidek, Padova, Italy) were documented at four weeks and twelve weeks postoperatively. The indication for epiretinal membrane (ERM) surgery was based on the degree and type of functional impairment, including VA values associated whether or not with complain of blurred vision referred by the patient, central retinal thickness (CRT) measured with HD-OCT and macular sensitivity tested using MP1.
Before the surgery, mean BCVA ± standard deviation for 38 studied eyes was 0.68 ± 0.22. Four weeks after surgery, BCVA improved to 0.59 ± 0.14 and it was not statistically significant (P = .3). Overall at 12 weeks after surgery, 36 (94.7%) out of the 38 studied eyes had statistical significant improvement in visual acuity compared with preoperative results: 0.51 ± 0.26 (P = .042). The pre-operative mean CRT ± standard deviation was 357,9 ± 57,5 microns in the 38 eyes. Twelve weeks after surgery the mean reduction ± standard deviation of CRT was 77.1 ± 12.2 micron. Preoperatively, functional macular mapping of the 38 eyes showed a mean sensitivity ± standard deviation of 12.6 ± 4.0 dB. Twelve weeks after surgery, the mean sensitivity of the 38 patients was statistically significant better than before surgery: 14.1 ± 4.3 dB (P = .037). After twelve weeks of follow-up there was no statistically significant correlation between postoperatively VA improvement with both retinal sensitivity and the CRT values.
Pars plana vitrectomy for macular pucker improves functional vision including retinal sensitivity not measurable by VA. Therefore, evaluation of functional vision using a MP1 should be included in surgical case planning for assessing the disease entity.
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