Prognostic factors and macular morphology changes and nerve fiber ganglion layer changes after pars plana vitrectomy

Session Details

Session Title: Free Paper Session 13: Vitreoretinal Surgery IV

Session Date/Time: Friday 08/09/2017 | 14:30-16:00

Paper Time: 15:12

Venue: Room 117

First Author: : K.Montes Leon COLOMBIA

Co Author(s): :    F. Rodriguez-Alvira   M. Ibanez                          

Abstract Details

Purpose:

To determine prognostic factors, macular morphology and nerve fiber ganglion layer changes after pars plana vitrectomy.

Setting:

To determine prognostic factors, macular morphology and nerve fiber ganglion layer changes after pars plana vitrectomy.

Methods:

Longitudinal trial, before and after pars plana vitrectomy (3 and 6 months) involving patients with epiretinal membrane, macular hole, macular vitreous traction syndrome and noninflammatory vitreous opacities. Clinical and optic coherence tomography monitoring was done. Data analysis was performed with statistical program SPSS Statistics 20.0 for Windows (SPSS Inc., Chicago,IL) and Microsoft Excel for Windows (Microsoft Corp., Redmond, WA). A descriptive analysis of the study variables and normality tests were performed. Correlation between variables was evaluated with Spearman's non-parametric correlation coefficient because visual acuity and other variables do not have a normal distribution; all variables with baseline, three and six months values were analyzed. Differences between baseline, three and six months visual acuity changes with the presence or absence of internal and external segment junctions (IS/OS), as well as presence of posterior vitreous detachment, thickness of GNFL, mean CFT, all variables with baseline, three and six months values were analized with the exact non-parametric U Mann-Whitney test because no normality was found with Shapiro-Wilk test or Friedman's non-parametric test. A r-square ordinal regression model was used to select predictive factors for visual acuity at three months of vitrectomy. Finally, 60 eyes of 60 patients (one eye per patient) were included.

Results:

Sixty patients (65.0% women), with average age of 65.45+9.49 years, and mean disease duration of 23+29.79 months. The indications for pars plana vitrectomy (n=60eyes) were macular hole (38.3%) and epiretinal membrane (36.7%). Significant difference was observed in the thickness of ganglion cell layer (GCL)+inner plexiform layer (IPL) complex at baseline and third months (p=0.039), correlation between GCL + IPL complex at third and sixth months (r=0.704,p<0.001) and GCL + IPL complex at third month with CFT at third and sixth months (r=–0.594,p<0.001 and r=–0.595,p=0.001). Patients older than 65 years have less GCL thickness at six months (r=-0.528,p=0.007). GCFL average thickness and the presence of ellipsoid layer were baseline predictors of good visual acuity after pars plana vitrectomy (r2=0.414,p=0.018, and r2=0.414,p=0.010).

Conclusions:

Ganglion nerve fiber layer (GNFL) thickness and the presence of the ellipsoid zone at baseline are highly predictive of good visual acuity at the third postoperative month of pars plana vitrectomy and there is an inverse correlation between GCL + IPL complex with CFT at third and sixth months after pars plana vitrectomy.

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