Effects of vitrectomy on age-related macular degeneration.
OBJECTIVE
To determine whether vitrectomy alters the long-term progression of age-related macular degeneration (AMD).


METHODS
Retrospective case-control study.


METHODS
Forty-four eyes of 22 patients with AMD who underwent vitrectomy in 1 eye were included in the study. The progression of AMD at follow-up in the 22 eyes that underwent vitrectomy was compared with the 22 fellow, nonvitrectomized eyes.


METHODS
The charts and photographs of subjects with Age-Related Eye Disease Study category 3 AMD in both eyes who previously underwent vitrectomy surgery for an epiretinal membrane or macular hole were reviewed. Subjects were excluded if they had had a vitrectomy in both eyes, had <2 years of follow-up, had previous choroidal neovascularization (CNV), retinal detachment, diabetic retinopathy, angioid streaks, high myopia, vascular occlusions, or extensive macular scarring in either eye, or insufficient hospital records or photographs to determine the extent of AMD. Clinical notes throughout the follow-up interval were reviewed. Two vitreoretinal specialists independently graded pre- and postvitrectomy fundus photographs of all eyes in a masked fashion.


METHODS
The development or progression of geographic atrophy of the retinal pigment epithelium and the development of CNV.


RESULTS
Twenty-two patients were included. The average follow up interval was 5.5 years (range, 2-15). Choroidal neovascularization developed in 5 control eyes and in 2 vitrectomized eyes, and atrophy developed in 7 control and 4 vitrectomized eyes. The difference between vitrectomized eyes and fellow eyes for the combined end points of RPE geographic atrophy or CNV was significant (P = 0.02).


CONCLUSIONS
In this pilot study, we did not detect that vitrectomy increased the progression of AMD. In fact, it was associated with a reduced progression to geographic atrophy or CNV. Additional studies are needed to confirm or refute this association.


BACKGROUND
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Roller
A Brock
AB
Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, The University of Iowa Hospitals & Clinics, Iowa City, Iowa 52242, USA. aaron-roller@uiowa.edu
Mahajan
Vinit B
VB
Boldt
H Culver
HC
Abramoff
Michael D
MD
Russell
Stephen R
SR
Folk
James C
JC
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D020256:Choroidal Neovascularization / Q000503:physiopathology; D018450:Disease Progression; D019773:Epiretinal Membrane / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D057092:Geographic Atrophy / Q000503:physiopathology; D006801:Humans; D008268:Macular Degeneration / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy