MACULAR FUNCTION AND MORPHOLOGY AFTER MEMBRANE PEELING IN IDIOPATHIC EPIRETINAL GLIOSIS WITH AND WITHOUT INDOCYANINE GREEN (ICG)

Abstract

Abstract: : Purpose: To retrospectively investigate macular function after surgical peeling of epiretinal membrane in idiopathic epiretinal gliosis with and without assistance of ICG. Methods: A total of 22 patients, 13 female, 9 male, mean age 66 years, underwent standard 3–port pars–plana vitrectomy with removal of epiretinal membrane. In 12 patients ICG with a 0.1% concentration dissolved in glucose 5% was used to stain the epiretinal membrane. 10 patients underwent the identical procedure but without use of ICG. 4 patients in each group were phakic, all other patients were pseudophakic. Post–op follow–up was at 1–24 months (mean 8.5 months). Functional outcome was assessed with best–corrected visual acuity (BCVA), 10° and 30° automated perimetry (Heidelberg visual field analyser) (HFA) and Goldmann kinetic perimetry. Macular morphology was assessed with optical coherence tomography (OCT) and stereoscopic biomicroscopy. Results: BCVA improved in 14 patients, remained unchanged in 6 patients and decreased in 2 patients. Change of BCVA was statistically not different between the two groups. Mean BCVA in patients operated with ICG improved from preop 0.34 (range 0.1–0.6) to postop 0.55 (range 0.3–0.9). Mean BCVA in patients operated without ICG improved from preop 0.36 (range 0.16–0.8) to postop 0.45 (range 0.3–1.0). In 2 patients operated with ICG and in 2 patients operated without ICG small visual field defects were detected by HFA but in these patients test compliance was poor and the defects were not reproducable by Goldmann perimetry. OCT and stereoscopic biomicroscopy showed a decrease of macular edema in all patients. Conclusion: The functional and morphological results of this ongoing study suggest that removal of epiretinal tissue with or without assistance of ICG improves visual function and reduces macular edema in most patients. Adverse effects of ICG were not observed but further investigation in a greater number of patients is warranted.

Keywords: vitreoretinal surgery • macula/fovea • visual fields