Abstract
Purpose :
To investigate impact of glaucoma on central visual field (VF) changes after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM).
Methods :
This retrospective cohort study consists of consecutive cases with or without glaucoma who underwent vitrectomy with ILM peeling for ERM. Humphrey 10-2 VF tests and ophthalmic examinations were performed preoperatively and three times at 3, 6, and 12 months postoperatively. Main outcome measures were; longitudinal changes in VF parameters and mean total deviation (TD) changes in six sectors (i.e. superior/inferior outer arcuate, inner arcuate, cecocentral sectors) derived from 10-2 VF test points. Factors related to the sectoral TD changes were also investigated by linear-mixed models.
Results :
Seventy-six eyes from 76 patients were enrolled (control, 40 eyes; glaucoma, 36 eyes). Baseline 10-2 mean deviation (MD) values in the glaucoma and the control groups were -7.8 ± 5.6 dB and -2.0 ± 1.2 dB, respectively. The glaucoma had a significant impact on the worsening trend in MD and pattern standard deviation changes after vitrectomy (P<0.001). Sectorwise VF analysis revealed that the mean TD values in the superior outer arcuate, superior inner arcuate, and inferior outer arcuate sectors significantly deteriorated in the glaucoma group (P<0.001, = 0.042, and 0.042, respectively). In the glaucoma group, the mixed model analysis revealed thinner preoperative GCC thickness and older age were significant factors related to the VF deterioration in the superior outer arcuate sector [Coefficient ± standard error (P values); 0.008 ± 0.002 (<0.001), -0.011 ± 0.004 (0.018), respectively]. In addition, worse baseline TD values were significantly associated with the worse postoperative sensitivity in the superior cecocentral, inferior outer arcuate, and inferior inner arcuate sectors [0.038 ± 0.012 (0.006), 0.066 ± 0.012 (<0.001), 0.032 ± 0.006 (<0.001), respectively].
Conclusions :
VF within the central 10 degrees, especially in the outer arcuate and superior inner arcuate sectors, may deteriorate after vitrectomy with ILM peeling in glaucomatous eyes. Thinner preoperative GCC thickness and older age may contribute to the postoperative VF deterioration in the superior outer arcuate sector in eyes with glaucoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.