Functional and morphological results of treatment of macula-on and macula-off rhegmatogenous retinal detachment with pars plana vitrectomy and sulfur hexafluoride gas tamponade

Dorota Borowicz, Katarzyna Nowomiejska, Dominika Nowakowska, Agnieszka Brzozowska, Mario D Toro, Teresio Avitabile, Anselm G Jünemann, Robert Rejdak, Dorota Borowicz, Katarzyna Nowomiejska, Dominika Nowakowska, Agnieszka Brzozowska, Mario D Toro, Teresio Avitabile, Anselm G Jünemann, Robert Rejdak

Abstract

Background: To examine morphological and functional results after pars plana vitrectomy (PPV) with sulfur hexafluoride (SF6) gas tamponade due to macula-on and macula-off rhegmatogenous retinal detachment (RRD) during 6 months of the follow-up.

Methods: The study included 62 eyes that underwent successful PPV with SF6 tamponade with macula-on (34 eyes) and macula-off (28 eyes) RRD preoperatively. The best-corrected visual acuity (BCVA), Amsler test, M-charts, optical coherence tomography (OCT) and microperimetry were performed at 1, 3 and 6 months postoperatively.

Results: Results of the Amsler test were abnormal postoperatively in 54% of the patients in the group with macula-off and in 32% of the patients with macula-on RRD. Horizontal M-charts improved significantly from 0.33 to 0.2, vertical M-charts- from 0.29 to 0.17 during 6 months of the follow-up. There was a significant increase in the central retinal thickness (CRT) and average thickness (AT) between follow-up examinations only in the macula-off group. 29 of 62 eyes (47%) after surgery (equally with macula-on and macula-off RRD) showed morphological changes in OCT in the macular region, as epiretinal membrane, macular edema, subretinal fluid or alterations of the outer layers of the retina. The average threshold in microperimetry increased significantly within both groups during the follow-up.

Conclusion: Both horizontal and vertical M-charts scores, as were as microperimetry sensitivity improved significantly during the 6 months of the follow-up both in macula-on and macula-off group. Although PPV with SF6 gas tamponade was successful, almost half of eyes revealed anatomical changes in the macular region in OCT both with macula-on and macula-off group.

Trial registration: Current Controlled Trials NCT03902795 registered on 03/04/2019. Retrospectively registered.

Keywords: M-charts; Metamorphopsia; Microperimetry; Rhegmatogenous retinal detachment.

Conflict of interest statement

The authors declare that they have no competing interests.

Katarzyna Nowomiejska declares that she is a member of the editorial board of this journal.

Figures

Fig. 1
Fig. 1
Median best corrected visual acuity (BCVA) in logMAR scale before and 1, 3 and 6 months after the vitrectomy due to rhegmatogenous retinal detachment in two groups of patients with macula-on and macula-off preoperatively
Fig. 2
Fig. 2
Median central retinal thickness (CRT) in micrometers obtained with optical coherence tomography during 6 months of the follow-up after vitrectomy due to rhegmatogenous retinal detachment
Fig. 3
Fig. 3
Median average thickness (AT) in micrometers obtained with ocular coherence tomography during 6 months of the follow-up after vitrectomy due to rhegmatogenous retinal detachment
Fig. 4
Fig. 4
Median horizontal metamorphopsia (M-charts H) scores during 6 months of the follow-up after vitrectomy due to rhegmatogenous retinal detachment
Fig. 5
Fig. 5
Median vertical metamorphopsia (M-charts V) scores during 6 months of the follow-up after vitrectomy due to rhegmatogenous retinal detachment
Fig. 6
Fig. 6
Median average threshold (AT) in decibels of retinal sensitivity in microperimetry during 6 months of the follow-up after vitrectomy due to rhegmatogenous retinal detachment

References

    1. D’Amico DJ. Clinical practice primary retinal detachment. N Engl J Med. 2008;359(22):2346–2354. doi: 10.1056/NEJMcp0804591.
    1. Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol. 2010;94(6):678–684. doi: 10.1136/bjo.2009.157727.
    1. Hakin KN, Lavin MJ, Leader PK. Primary vitrectomy for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1993;231(6):344–346. doi: 10.1007/BF00919031.
    1. Lin Z, Sun JT, Wu RH, Moonasar N, Zhou YH. The safety and efficacy of adjustable postoperative position after pars plana vitrectomy for rhegmatogenous retinal detachment. J Ophthalmol. 2017;2017:5760173.
    1. Neffendorf JE, Gupta B, Williamson TH. The role of intraocular gas tamponade in rhegmatogenous retinal detachment. Retina. 2017;26.
    1. Zhou C, Qiu Q, Zheng Z. Air versus gas tamponade in rhegmatogenous retinal detachment with inferior breaks after 23-gauge pars plana vitrectomy: a prospective, randomized comparative interventional study. Retina. 2015;35:886–891. doi: 10.1097/IAE.0000000000000416.
    1. van de Put MA, Croonen D, Nolte IM, Japing WJ, Hooymans JM, Los LI. Postoperative recovery of visual function after macula-offmacula-off rhegmatogenous retinal detachment. PLoS One. 2014;9(6):e99787. doi: 10.1371/journal.pone.0099787.
    1. Lina G, Xuemin Q, Qinmei W, Lijun S. Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhematogenous retinal detachment. Eye (Lond) 2016;30(1):40–45. doi: 10.1038/eye.2015.171.
    1. Okuda T, Higashide T, Sugiyama K. Metamorphopsia and outer retinal changes after successful vitrectomy surgery for macula-off rhematogenus retinal detachment. Retina. 2018;38(1):148–154. doi: 10.1097/IAE.0000000000001510.
    1. Amsler M. L”examen qualitatif de la fonction maculaire. Ophthalmologica. 1947;114(4–5):248–261. doi: 10.1159/000300476.
    1. Matsumoto C, Tsuboi S, Okuyama S, Uyama K, Otori T. Quantification of metamorphopsia. Method of evaluation. Rinho Ganka. 1990;44:271–4.
    1. Arimura E, Matsumoto C, Nomoto H, Hashimoto S, Takada S, Okuyama S, et al. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases. Invest Ophthalmol Vis Sci. 2011;52(1):128–135. doi: 10.1167/iovs.09-3535.
    1. Laishram M, Srikanth K, Rajalakshmi AR, Nagarajan S, Ezhumalai G. Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases. J Clin Diagn Res. 2017;11(7):NC08–11.
    1. Wang Y, Li SY, Zhu M, Chen SJ, Liu Y, Men XH, Gillies M, Larsson J. Metamorphopsia after successful retinal detachment surgery: an optical coherence tomography study. Acta Ophthalmol Scand. 2005;83:168–171. doi: 10.1111/j.1600-0420.2005.00413.x.
    1. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Metamorphopsia and optical coherence tomography findings after rhegmatogenous retinal detachment surgery. Am J Ophthalmol. 2014;157(1):214–220. doi: 10.1016/j.ajo.2013.08.007.
    1. Murakami T, Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Changes in metamorphopsia and optical coherence tomography finding after successful retinal detachment surgery. Retina. 2018;38(4):684–691. doi: 10.1097/IAE.0000000000001588.
    1. Rezar S, Sacu S, Blum R, Eibenberger K, Schmidt-Erfurth U, Georgopoulos M. Macula-on versus macula-off Pseudophakic Rhegmatogenous retinal detachment following primary 23-gauge vitrectomy plus Endotamponade. Curr Eye Res. 2016;41(4):543–550. doi: 10.3109/02713683.2015.1031351.
    1. Potic J, Bergin C, Giacuzzo C, Daruich A, Konstantinidis L, Wolfensberger TJ. Primary rhegmatogenous retinal detachment: risk factors for macular involvement. Graefes Arch Clin Exp Ophthalmol. 2018;256(3):489–494. doi: 10.1007/s00417-017-3880-x.
    1. Ross W, Lavina A, Russell M, Maberley D. The correlation between height of macular detachment and visual outcome in macula-off retinal detachments of < or = 7 days’ duration. Ophthalmology. 2005;112(7):1213–1217. doi: 10.1016/j.ophtha.2005.01.040.
    1. Liu F, Meyer CH, Mennel S, Hoerle S, Kroll P. Visual recovery after scleral buckling surgery in macula-off rhegmatogenous retinal detachment. Ophthalmologica. 2006;220(3):174–180. doi: 10.1159/000091761.
    1. McGowan G, Yorston D, Strang N, Manahilov V. D-charts a novel method of measuring metamorphopsia in epiretinal membrane and macular hole. Retina. 2016;36(4):703–708. doi: 10.1097/IAE.0000000000000778.
    1. Nowomiejska K, Oleszczuk A, Brzozowska A, Grzybowski A, Ksiazek K, Maciejewski R, Ksiazek P, Juenemann A, Rejdak R. M-charts as a tool for quantifying metamorphopsia in age-related macular degeneration treated with the bevacizumab injection. BMC Ophthalmol. 2013;13:13. doi: 10.1186/1471-2415-13-13.
    1. Manabe K, Tsujikawa A, Osaka R, Nakano Y, Fujita T, Shiragami C, et al. Metamorphopsia associated with branch retinal vein occlusion. PLoS One. 2016;11(4):e0153817. doi: 10.1371/journal.pone.0153817.
    1. Manabe K, Osaka R, Nakano Y, Takasago Y, Fujita T, Shiragami C, et al. Metamorphopsia associated with central retinal vein occlusion. PLoS One. 2017;12(10):e0186737. doi: 10.1371/journal.pone.0186737.
    1. Fujita K, Imamura Y, Shinoda K, Matsumoto S, Mizutani Y, Mizota A, Yuzawa M. Quantification of metamorphopsia in chronic central serous chorioretinopathy after half-dose verteporfin photodynamic therapy. Retina. 2014;34(5):964–970. doi: 10.1097/IAE.0000000000000027.
    1. Arimura E, Matsumoto C, Okuyama S, Takada S, Hashimoto S, Shimomura Y. Retinal contraction and metamorphopsia scores in eyes with idiopathic epiretinal membrane. Invest Ophthalmol Vis Sci. 2005;46:2961–2966. doi: 10.1167/iovs.04-1104.
    1. Wakabayashi T, Oshima Y, Fujimoto H, Murakami Y, Sakaguchi H, Kusaka S, Tano Y. Foveal microstructure and visual acuity after retinal detachment repair: imaging analysis by Fourier-domain optical coherence tomography. Ophthalmology. 2009;116(3):519–528. doi: 10.1016/j.ophtha.2008.10.001.
    1. Benson SE, Schlottmann PG, Bunce C, Xing W, Charteris DG. Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment. Ophthalmology. 2006;113(7):1179–1183. doi: 10.1016/j.ophtha.2006.01.039.
    1. Cheng JH, Ku CH, Tai MC, Chen CL, Chen JT, Lu DW. Optical coherence tomography analysis of the macula after macula-off Rhegmatogenous retinal detachment surgery. J Med Sci. 2009;29(4):173–178.
    1. Rossetti A, Doro D, Manfre A, Midena E. Long-term follow-up with optical coherence tomography and microperimetry in eyes with Metamorphopsia after macula-off retinal detachment repair. Eye. 2010;24:1808–1813. doi: 10.1038/eye.2010.138.
    1. Lai W, Leung GY, Chan CW, Yeung IY, Wong D. Simultaneous spectral domain OCT and fundus autofluorescence imaging of the macula and microperimetric correspondence after successful repair of rhegmatogenous retinal detachment. Br J Ophthalmol. 2010;94(3):311–318. doi: 10.1136/bjo.2009.163584.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir