Visual fields in patients who have undergone vitrectomy for complications of diabetic retinopathy. A prospective study.
BACKGROUND
To determine the extent of visual field loss in patients who had required a pars plana vitrectomy secondary to complications of proliferative diabetic retinopathy.


METHODS
Patients that had undergone a vitrectomy on at least one eye for treatment of either vitreous haemorrhage or tractional retinal detachment were selected for study. ETDRS acuity and Humphrey binocular Esterman visual field testing were performed and compared to the minimum standards for safe driving as defined by the Royal College of Ophthalmologists in 1999. In addition to this Goldman kinetic visual fields using a III4e and V4e stimulus size and central 24-2 threshold test with the SITA-fast strategy were performed on the vitrectomised eye.


RESULTS
20 patients (n = 20) were recruited. Mean visual acuity in the eye being tested was 0.20 (Snellen 6/9.5). Results from the Humphrey field analyzer showed a mean number of abnormal stimulus locations of 71.2% (p < 0.005). 70% of patients had sufficient binocular acuity to drive and of these 71.4% were shown not to have a minimum visual field for safe driving on binocular Esterman field analysis.


CONCLUSIONS
Vitrectomy potentially allows retention/restoration of good visual acuity in patients with complications of proliferative diabetic retinopathy. However patients may be suffering from unrecognized visual impairment consequent upon extensive visual field loss which in over two thirds of patients may be sufficiently severe to preclude safe driving.
Barsam
Allon
A
Department of Ophthalmology, St Thomas' Hospital, SE1 7EH, London. abarsam@hotmail.com
Laidlaw
Alistair
A
D000328:Adult; D000368:Aged; D001334:Automobile Driving; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012163:Retinal Detachment / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity; D014794:Visual Fields; D014821:Vitrectomy / Q000009:adverse effects*; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*