Anatomy and function of the macula after surgery for retinal detachment complicated by proliferative vitreoretinopathy.
OBJECTIVE
To investigate the macular changes following silicone oil removal after surgery for complicated retinal detachment (RD) with proliferative vitreoretinopathy (PVR).


METHODS
Retrospective interventional case series.


METHODS
setting: Vienna, Austria. study population: Thirty-nine patients with attached retina after silicone oil removal following previous vitrectomy and silicone oil tamponade for complicated RD and PVR grade C3 and worse. observation procedures: Examination of macular anatomy with biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography (FA). Macular function was tested by assessing logMAR distance visual acuity (VA) using Early Treatment Diabetic Retinopathy Study (ETDRS) charts and reading acuity and reading speed using a standardized test (Radner charts). main outcome measures: Macular anatomy, VA, reading acuity, and reading speed.


RESULTS
The macula was clinically normal in five patients (12.8%). Retinal pigment epithelium (RPE) irregularities were found in nine patients (23.1%). Eight patients (20.5%) had macular pucker, seven (18.0%) had cystoid macular edema (CME), and 10 (25.6%) had subretinal fibrosis. The mean VA of all patients was logMAR 0.67 +/- 0.68 (range, -0.1 to 3.0). Six eyes did not achieve reading acuity. The distance VA of the remaining 33 eyes was logMAR 0.44 +/- 0.29 and their mean reading acuity was logRAD 0.62 +/- 0.35, with a reading speed ranging from 55 to 240 words per minute.


CONCLUSIONS
We found macular changes in 87% of the patients, one-third thereof being eligible for further treatment (macular pucker or CME). Thus, the majority of these patients do not seem to be eligible for a further improvement of anatomic or functional outcome.
Kiss
Christopher G
CG
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. christopher.kiss@meduniwien.ac.at
Richter-Müksch
Sibylla
S
Sacu
Stefan
S
Benesch
Thomas
T
Velikay-Parel
Michaela
M
D004322:Drainage / Q000379:methods; D005451:Fluorescein Angiography; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology*; D033401:Microscopy, Acoustic; D012163:Retinal Detachment / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D012827:Silicone Oils; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000150:complications / Q000503:physiopathology* / Q000601:surgery
D012827:Silicone Oils