Recovery of visual field and acuity after removal of epiretinal and inner limiting membranes.

Abstract

BACKGROUND:

Visual acuity serves as only a rough gauge of macular function. The aim therefore was to ascertain whether central an assessment of the central visual field afforded a closer insight into visual function after removal of epiretinal membranes and Infracyanine-Green- or Trypan-Blue-assisted peeling of the inner limiting membrane.

PATIENTS AND METHODS:

Fourty-three patients undergoing pars-plana vitrectomy for the removal of epimacular membranes and dye-assisted peeling of the inner limiting membrane using either Infracyanine Green (n = 29; group 1) or Trypan Blue (n = 14; group 2) were monitored prospectively for 12 months. Preoperatively, and 1, 6 and 12 months postoperatively, distance and reading visual acuities were evaluated; the central visual field was assessed by automated static perimetry.

RESULTS:

Twelve months after surgery, distance and reading visual acuities had improved in both groups, but to a significant degree only in Trypan-Blue-treated eyes. The difference between the two groups was not significant. Likewise at this juncture, the mean size of the visual-field defect remained unchanged in Trypan-Blue-treated eyes (preoperative: 4.3 (SD 2.1) dB; 12 months: 4.0 (2.1) dB (p = 0.15)), but had increased in Infracyanine-Green-treated ones (from 5.3 (3.7) dB to 8.0 (5.2) dB (p = 0.027)).

CONCLUSION:

Unlike visual acuity, the central visual field had deteriorated in Infracyanine-Green-treated eyes but not in Trypan-Blue-treated eyes 12 months after surgery. Hence, as a predictor of functional outcome, testing of the central visual field may be a more sensitive gauge than visual acuity. Furthermore, Infracyanine Green may have a chronic and potentially clinically relevant effect on the macula which is not reflected in the visual acuity.

• Authors: J G Garweg, D Bergstein, B Windisch, F Koerner, M Halberstadt
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 92 Issue 2 Pg. 220-4 (Feb 2008) ISSN: 1468-2079 [Electronic] England
• PMID: 18055572 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Coloring Agents
• Infracyanine green
• Trypan Blue
• Indocyanine Green

Topics

• Aged
• Coloring Agents (adverse effects)
• Epiretinal Membrane (physiopathology, surgery)
• Humans
• Indocyanine Green (adverse effects, analogs & derivatives)
• Middle Aged
• Prospective Studies
• Treatment Outcome
• Trypan Blue (adverse effects)
• Vision Disorders (chemically induced, physiopathology)
• Visual Acuity (drug effects)
• Visual Field Tests
• Visual Fields (drug effects)
• Vitrectomy (methods)