FACTORS RELATED TO UNFAVORABLE VISUAL OUTCOME AFTER IDIOPATHIC EPIRETINAL MEMBRANE SURGERY IN PATIENTS WITH GLAUCOMA.
Ko Yu-Chieh, Chen Yen-Cheng, Huang Yi-Ming, Chang Yu-Fan, Chou Yu-Bai, Liu Catherine Jui-Ling, Chen Shih-Jen
AI Summary
Glaucoma patients undergoing ERM surgery have poorer visual outcomes than non-glaucoma patients, especially with advanced visual field defects. Preoperative visual field testing is crucial for prognosis.
Abstract
Purpose
To evaluate the visual outcomes after idiopathic epiretinal membrane surgery in glaucomatous and nonglaucomatous eyes and factors related to unfavorable outcomes in glaucomatous eyes.
Methods
This was a retrospective cohort study including patients undergoing idiopathic epiretinal membrane surgery with ≥12-month follow-up. Final visual acuity at pseudophakic status was compared among groups of glaucoma, glaucoma suspect, and nonglaucoma and correlated with optical coherence tomography and visual field characteristics in patients with glaucoma.
Results
Of the 314 patients enrolled, 31 had glaucoma and 22 were glaucoma suspect. Baseline visual acuity and central foveal thickness were similar across the groups. Most patients had improved/stable visual acuity postoperatively, with a lower proportion of 83.9% with glaucoma than 96.9% and 100% without glaucoma and glaucoma suspect, respectively (P = 0.002). The mean visual acuity did not change in the glaucoma group (from 6/29 to 6/23), but it improved from 6/25 to 6/12 (a gain of 16.7 approxETDRS letters) in nonglaucoma and 6/26 to 6/14 in glaucoma suspect (a gain of 14.0 approxETDRS letters) (both P < 0.001). The change of visual acuity was correlated with preoperative visual field defects (P < 0.001, r2 = 0.554). Patients with glaucoma with more advanced, fixation-threatening defects or temporally located inner nuclear layer microcysts were more likely to have worsened visual acuity.
Conclusion
Visual field testing is imperative for patients with glaucoma before idiopathic epiretinal membrane surgery for outcome assessment.
MeSH Terms
Shields Classification
Key Concepts5
In a retrospective cohort study of 314 patients undergoing idiopathic epiretinal membrane surgery, the proportion of patients with improved/stable visual acuity postoperatively was lower in the glaucoma group (83.9%) compared to the nonglaucoma group (96.9%) and glaucoma suspect group (100%) (P = 0.002).
In a retrospective cohort study of 314 patients undergoing idiopathic epiretinal membrane surgery, the mean visual acuity did not change in the glaucoma group (from 6/29 to 6/23) postoperatively, while it improved from 6/25 to 6/12 (a gain of 16.7 approxETDRS letters) in the nonglaucoma group and from 6/26 to 6/14 (a gain of 14.0 approxETDRS letters) in the glaucoma suspect group (both P < 0.001).
In patients with glaucoma undergoing idiopathic epiretinal membrane surgery (n=31), the change of visual acuity was correlated with preoperative visual field defects (P < 0.001, r2 = 0.554).
In patients with glaucoma undergoing idiopathic epiretinal membrane surgery (n=31), those with more advanced, fixation-threatening visual field defects or temporally located inner nuclear layer microcysts were more likely to have worsened visual acuity postoperatively.
Visual field testing is imperative for patients with glaucoma before idiopathic epiretinal membrane surgery for outcome assessment.
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