J Korean Ophthalmol Soc.  2019 Oct;60(10):966-974. 10.3341/jkos.2019.60.10.966.

Visual Field Changes after Internal Limiting Membrane Peeling in Glaucoma Patients with Epiretinal Membrane

Affiliations
  • 1Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. chrisahn@ajou.ac.kr

Abstract

PURPOSE
To report visual field changes after internal limiting membrane (ILM) peeling for macular epiretinal membrane (ERM) according to the severity of glaucoma.
METHODS
A retrospective review of 37 eyes from 37 patients who underwent ILM peeling to treat ERM. Standard automated perimetry (Humphrey visual field 24-2 program) was performed preoperatively and postoperatively. Based on the Advanced Glaucoma Intervention Study (AGIS) scoring system of preoperative visual field, patients were classified into the early glaucoma (AGIS ≤ 1) group or the advanced glaucoma (AGIS ≥ 2) group. Postoperative visual field sensitivity at each point was compared with the preoperative value.
RESULTS
Out of 37 eyes, 15 eyes had early glaucoma and 22 had advanced glaucoma. Eyes from both groups had poor postoperative visual field parameters. For eyes with advanced glaucoma, the visual field index was significantly reduced and the visual field damage was larger and wider compared to those with early glaucoma. In both groups, visual field impairment was greater on the nasal side than on the temporal side, and visual acuity was not significantly different. Postoperatively, the macular ganglion cell-inner plexiform layer thickness was decreased, especially on the temporal side of advanced glaucoma.
CONCLUSIONS
Visual field impairment was greater and wider in eyes with advanced glaucoma than in those with early glaucoma after ILM peeling in patients with ERM.

Keyword

Advanced glaucoma intervention study score; Epiretinal membrane; Ganglion cell-inner plexiform layer; Internal limiting membrane peeling; Visual field defect

MeSH Terms

Epiretinal Membrane*
Ganglion Cysts
Glaucoma*
Humans
Membranes*
Retrospective Studies
Visual Acuity
Visual Field Tests
Visual Fields*

Figure

  • Figure 1 Comparison of postoperative changes in visual field parameters in early and advanced glaucoma. (A) Best-corrected visual acuity (logMAR). (B) Visual field index. (C) Mean deviation. (D) Pattern standard deviation. BCVA = best-corrected visual acuity; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation; logMAR = logarithm of the minimal angle of resolution.

  • Figure 2 Mean retinal sensitivity changes at each point of 24-2 Humphrey VF of each group. The 12 central boxes surrounded by bold lines are located within 10 eccentricity. The gray boxes indicated significantly deteriorated points postoperatively. (A) Early glaucoma. (B) Advanced glaucoma. Values are shown as the mean ± standard deviation (dB). *p < 0.05.

  • Figure 3 Longitudinal changes in visual field parameters in early and advanced glaucoma. (A) Best-corrected visual acuity (logMAR). (B) Visual field index. (C) Mean deviation. (D) Pattern standard deviation. BCVA = best-corrected visual acuity; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation; logMAR = logarithm of the minimal angle of resolution.


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