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Recovery of visual field and acuity after removal of epiretinal and inner limiting membranes
  1. J G Garweg1,2,3,
  2. D Bergstein2,
  3. B Windisch4,
  4. F Koerner2,
  5. M Halberstadt1,5
  1. 1
    Clinic for Vitreoretinal Disease, Swiss Eye Institute, Bern, Switzerland
  2. 2
    Medical Faculty, University of Bern, Bern, Switzerland
  3. 3
    Department of Ophthalmology, Inselspital Bern, Bern, Switzerland
  4. 4
    Department of Ophthalmology and Visual Sciences, Dalehouse University, Halifax, NS, Canada
  5. 5
    Department of Ophthalmology, Medizinische Hochschule Hannover, Hannover, Germany
  1. Professor J G Garweg, Clinic for Vitreoretinal Disease, Swiss Eye Institute, Bremgartenstr. 119, CH-3012 Bern, Switzerland; justus.garweg{at}swiss-eye-institute.com

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.

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Footnotes

  • Competing interests: None.

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