Visual field defect after pars plana vitrectomy. 1998

H Yan, and L Dhurjon, and D R Chow, and D Williams, and J C Chen
Department of Ophthalmology, Tianjin Medical University Hospital, Peoples Republic of China.

OBJECTIVE This study aimed to report the occurrence of visual field defects after pars plana vitrectomy (PPV) for the treatment of each of the following conditions: macular hole (MH), subretinal neovascular membrane (SRNVM), and epiretinal membrane proliferation (EMP). This study also aimed to speculate on the pathogenic mechanisms for the observed field defects. METHODS Noncomparative case series. METHODS The study included 48 subjects (50 eyes). Twenty-one of the 50 eyes had stage III MH, 13 eyes had SRNVM, and 16 eyes had EMP. METHODS Goldmann kinetic perimetry was performed postoperatively. METHODS Visual field defects. RESULTS Nine (18%) of the 50 eyes had visual field defects. Four (19%) of the 21 eyes with MH and 5 (38%) of the 13 eyes with SRNVM had visual field defects. Of the 16 patients who had epiretinal membrane peeling, none had a visual field defect. An air-fluid exchange had been performed in all patients found to have a postvitrectomy field defect. The difference in rate of visual field defects in eyes that had air-fluid exchange (EMP group) was statistically significant (P < 0.05, chi-square). No significant correlation was found between visual field defect and preoperative intraocular pressure, postoperative intraocular pressure, patient's age, and iatrogenic detachment of the vitreous cortex. The field defects identified were altitudinal (2 eyes), baring of the blind spot (1 eye), inferotemporal (3 eyes), inferonasal (2 eyes), and superonasal (1 eye). CONCLUSIONS Central and peripheral visual field defects may occur after PPV for the treatment of MHs or SRNVMs. Air-fluid exchange procedure was the common denominator in all of the patients found to have visual field deficit. The etiology is likely to be trauma to the optic nerve region during the air-fluid exchange procedure.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012167 Retinal Perforations Perforations through the whole thickness of the retina including the macula as the result of inflammation, trauma, degeneration, etc. The concept includes retinal breaks, tears, dialyses, and holes. Macular Holes,Retinal Breaks,Retinal Dialyses,Retinal Holes,Retinal Tears,Break, Retinal,Breaks, Retinal,Dialyses, Retinal,Hole, Macular,Hole, Retinal,Holes, Macular,Holes, Retinal,Macular Hole,Perforation, Retinal,Perforations, Retinal,Retinal Break,Retinal Dialyse,Retinal Hole,Retinal Perforation,Retinal Tear,Tear, Retinal,Tears, Retinal
D014786 Vision Disorders Visual impairments limiting one or more of the basic functions of the eye: visual acuity, dark adaptation, color vision, or peripheral vision. These may result from EYE DISEASES; OPTIC NERVE DISEASES; VISUAL PATHWAY diseases; OCCIPITAL LOBE diseases; OCULAR MOTILITY DISORDERS; and other conditions (From Newell, Ophthalmology: Principles and Concepts, 7th ed, p132). Hemeralopia,Macropsia,Micropsia,Day Blindness,Metamorphopsia,Vision Disability,Visual Disorders,Visual Impairment,Blindness, Day,Disabilities, Vision,Disability, Vision,Disorder, Visual,Disorders, Visual,Hemeralopias,Impairment, Visual,Impairments, Visual,Macropsias,Metamorphopsias,Micropsias,Vision Disabilities,Vision Disorder,Visual Disorder,Visual Impairments
D014794 Visual Fields The total area or space visible in a person's peripheral vision with the eye looking straightforward. Field, Visual,Fields, Visual,Visual Field

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