Abstract
Purpose :
We previously reported central visual field (VF) defect after vitrectomy with internal limiting membrane (ILM) peeling for glaucomatous eyes with macular diseases [epiretinal membrane (ERM) and macular hole (MH)] using 24-2 tests (Tsuchiya S, et al. Plos One 2017). Then we employed 10-2 tests to assess VF changes in eyes with and without glaucoma for further evaluations of the central VF changes after vitrectomy for ERM. This study demonstrated that the central visual field, particular in the nasal outer arcuate area in the central 10 degree, was deteriorated after vitrectomy for ERM in glaucoma patients (Tsuchiya S, et al. Eye 2020). Yet detailed central VF changes after vitrectomy for MH has not been reported. Thus, we evaluated the central VF changes with 10-2 tests after MH surgery in eyes with or without glaucoma.
Methods :
This prospective cohort study consists of patients with or without glaucoma who underwent MH surgery with 1-Year follow-up of 10-2 VF tests. Longitudinal changes of 10-2 MD and mean sensitivity (MS) in six sectors (outer/inner arcuate and cecocentral sectors in each hemifield) were analyzed. Factors associated with 10-2 MD changes were also explored with mixed model.
Results :
Thirty-three eyes of 33 patients (control, 20; glaucoma, 13) were enrolled. Best-corrected visual acuity significantly improved after vitrectomy in both groups (P < 0.001). 10-2 MD and 10-2 PSD significantly worsened only in the glaucoma group (P < 0.01). Sector-wise analysis revealed that the MS in the superior and inferior outer arcuate sectors significantly deteriorated over one year in the glaucoma group (P < 0.05). Worse 10-2 MD at baseline and longer axial length (AL) were significantly associated with 10-2 MD change in the glaucoma group (coefficient, 0.40, -0.36; standard error, 0.09, 0.16; P < 0.001, 0.036, respectively).
Conclusions :
In glaucomatous eyes with MH, the central VF, especially in the outer arcuate sectors, deteriorated after surgery. Preoperative worse VF and longer AL were identified as risk factors for postoperative VF deterioration.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.