Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study

Purpose To evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M). Patients and methods Retrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques. Results There were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) mu m and improved to 252.5 (153-1405) mu m. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months. Conclusions These results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M

Prognostic factors in eyes with severe proliferative diabetic retinopathy managed with pars plana vitrectomy

Purpose: To determine the prognostic factors of functional outcomes in eyes with severe proliferative diabetic retinopathy (PDR) managed with pars plana vitrectomy (PPV). Materials and Methods: A series of 136 consecutive eyes with severe PDR and non-clearing vitreous hemorrhage (VH) or retinal detachment (RD) that underwent PPV were retrospectively reviewed for prognostic risk factors of surgical outcomes and post-operative vision. Chi-square and logistic regression analysis were used for statistical analysis. Results: Average follow-up was 35 months (range 6-56). A functional outcome (VA>5/200) was achieved in 109 eyes (80.1%) and in 51 of 66 eyes (77.3%) with traction retinal detachment. The VA was improved two lines or more in 79 eyes (58.1%), unchanged in 37 (27.2%), and was worse by 2 lines or more in 20 eyes (14.7%). Complete retinal attachment was observed at the final visit in 122 eyes (89.7%). Predictors of a poor visual outcome were found to be preoperative neovascularization severity (p=0.02), presence of iris neovascularization (RI) (p=0.04), absence of prior pan-retinal photocoagulation (p=0.03), intraoperative fluid/gas exchange (p=0.003), iatrogenic retinotomy (p=0.04), postoperative RI (p=0.0001), recurrent VH (p=0.003), RD requiring PPV and/or buckle surgery (p=0.0001). Logistic regression analysis demonsrated that the significant factors responsible for poor functional outcome to be post-operative RI and RD. Conclusion: Vitreoretinal surgery has been demonstrated to preserve and improve vision in eyes with severe proliferative diabetic retinopathy. Counselling of patients who are to undergo surgery can be performed with a better understanding of the risks of major complications and the likely outcomes

Entoptic Phenomenon Following Pars Plana Vitrectomy Caused by Retained Preretinal Gel

WOS: 000264170000017PubMed: 19320311A patient who underwent pars plana vitrectomy for vitreous floaters is described. At the time of surgery, the posterior hyalold was avulsed and stripped from the posterior retinal surface. Postoperatively, the patient described filamentous and "sea-fan" entoptic phenomena scattered throughout the periaxial vision that were in focus, attached, and "waving" with movement that was counter to the direction of gaze pursuit and demonstrated after movement. The authors believe these structures represent vitreous gel retained at the retinal surface, even though the structures could not be demonstrated by optical coherence tomography or indocyanine green staining at later vitrectomy surgery. This case should raise caution when considering vitrectomy surgery that requires posterior hyalold stripping in patients with good vision. [Ophthalmic Surg Lasers Imaging 2009;40:188-191.]Vimetrics, Inc., Media, PennsylvaniaDr. Sinclair has proprietary and financial interest in Vimetrics, Inc., Media, Pennsylvania. The other authors have no financial or proprietary interest in the materials presented herein