Recovery of Visual Field and Acuity after Removal of Epiretinal and Inner Limiting Membranes
- Justus G. Garweg (justus.garweg{at}swiss-eye-institute.com),
- Daniel Bergstein (danberg{at}gmx.ch),
- Bettina Windisch (tiwi{at}planet.ch),
- Fritz Koerner (fritz.koerner{at}bbox.ch),
- Markus Halberstadt (markus.halberstadt{at}augenklinik-bern.ch)
- Swiss Eye Institute, Switzerland
- Regional Hospital Interlaken, Switzerland
- Siloah Hospital Guemligen, Switzerland
- Siloah Hospital Guemligen, Switzerland
- Swiss Eye Institute Bern, Switzerland
- Published Online First 30 November 2007
Abstract
Background: Visual acuity serves as only a rough gauge of macular function. We therefore wished 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 2 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±2.1dB; 12 months: 4.0±2.1dB (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 ones 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.
