Analysis of the Macula With Optical Coherence Tomography After Successful Surgery for Proliferative Vitreoretinopathy

Abstract

Objective: To use optical coherence tomography to assess the in vivo pathologic findings associated with incomplete visual recovery in patients who have undergone anatomically successful surgery to treat proliferative vitreoretinopathy. Methods: Eligible patients were recruited in vitreoretinal outpatient clinics between April 1, 2002, and July 31, 2003. Patients were included who had undergone anatomically successful vitreoretinal surgery to treat proliferative vitreoretinopathy and, at least 3 months after surgery, had postoperative vision worse than expected (Յ6/12) with no identifiable cause at clinical examination. Patients underwent optical coherence tomography, stereo fundus fluorescein angiography was performed in a cohort of patients, and angiographic findings were compared with those on the optical coherence tomograms. Relevant clinical data were collected retrospectively from patient case notes. Results: A total of 35 patients were recruited. Optical coherence tomograms revealed cystoid macular edema in 23 patients (66%) but did not identify any other specific intraretinal disease. Location of edema (outer or inner retina), determined with stereo fundus fluorescein angiography and optical coherence tomography, correlated well. Conclusions: Optical coherence tomography is a useful diagnostic tool for assessing poor postoperative visual acuity and can reveal disease undetected at clinical examination. Cystoid macular edema is a common finding on optical coherence tomograms in eyes with incomplete visual recovery after anatomically successful surgery to treat proliferative vitreoretinopathy.

Long-Term Microvascular Remodeling and Cystic Changes After Retinal Detachment Treated With Silicon Oil Tamponade

“…Previously published studies found variable incidence rates of macular edema after surgery with silicone tamponade (18%–66%). 9,10 As reported by Dormegny et al 7 we found a negative correlation between BCVA and cysts area. However, we did not find any more difference in BCVA between MC− eyes and MC+ eyes, perhaps because of an insufficient statistical power resulting from the small size of our cohort.…”

Structural and Functional Macular Changes After Retinectomy for Retinal Detachment Complicated by Proliferative Vitreoretinopathy

“…The remaining eyes were diagnosed with exudative maculopathy (51.5%), macular atrophy (22%), and tractional maculopathy (21.5%), differently from previous reports. 4,26,27…”

“…Most of these studies had small sample sizes. 4,26,27 High reattachment rates, defining the anatomic success, are in contrast to the functional outcome, which is linked to preoperative and postoperative macular status. In our series, we found postoperative normal macular profile on OCT in 3% of successful cases.…”

Slow-Release Dexamethasone in Proliferative Vitreoretinopathy

“…7,34 Our visual outcomes compare favorably to previous reports; however, a study investigating poor visual outcomes (<20/40) after successful RD repair for PVR in 35 patients reported a 66% incidence of CMO. 41 Given the lower incidence of macular edema observed in the adjunct group, one might have expected a correspondingly better visual outcome, especially when excluding eyes with limited visual potential. This observation is potentially important suggesting that retinal pathology other than macular edema such as neural retinal remodeling 42 may be the primary cause of the poor visual outcomes seen in PVR.…”