Abstract
Background
Visual field defects after uncomplicated vitrectomy have been reported but poorly explained. We describe two cases of nonarteritic anterior ischemic optic neuropathy (NAION) observed following vitrectomy. We also reviewed the literature for cases of post-vitrectomy visual field defects for evidence of optic nerve damage.
Methods
Two patients developed optic disc edema and features of an optic neuropathy after uncomplicated vitrectomy for macular hole and epiretinal membrane. A systematic literature search was conducted to obtain prior reports of visual field defects or ischemic optic neuropathy following vitrectomy. Additional studies were identified from the bibliographies of the retrieved articles.
Results
The incidence of visual field defects following vitrectomy has varied from 1–71% across all studies. Overall, we found 160 (14.5%) cases of unexplained visual field defects following vitrectomy out of 1,104 patients. Of these, 31 eyes (19.4%) have shown some sign of optic nerve damage following vitrectomy, including pallor in 29 eyes, relative afferent pupillary defect in eight eyes, and intrapapillary hemorrhage in two eyes.
Conclusions
NAION may develop following vitrectomy. “Visual field defects” following vitrectomy are common and many of the involved eyes demonstrate evidence of optic nerve damage, some of which may have represented NAION.
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References
Arima T, Uemura A, Otsuka S, Doi N, Nakao K (1998) Macular hole surgery-associated peripheral visual field loss. Jpn J Ophthalmol 42:476–483
Boldt HC, Munden PM, Folk JC, Mehaffey MG (1996) Visual field defects after macular hole surgery. Am J Ophthalmol 122:371–381
Bopp S, Lucke K, Hille U (1997) Peripheral visual field loss after vitreous surgery for macular holes. Graefe Arch Clin Exp Ophthalmol 235:362–371
Cullinane AB, Cleary PE (2000) Prevention of visual field defects after macular hole surgery. Br J Ophthalmol 84:372–377
Ezra E, Arden GB, Riordan-Eva P, Aylward GW, Gregor ZJ (1996) Visual field loss following vitrectomy for stage 2 and 3 macular holes. Br J Ophthalmol 80:519–525
Gass CA, Haritoglou C, Messmer EM, Schaumberger M, Kampik A (2001) Peripheral visual field defects after macular hole surgery: a complication with decreasing incidence. Br J Ophthalmol 85:549–551
Haritoglou C, Gass CA, Schaumberger M, Gandorfer A, Ulbig MW, Kampik A (2002) Long-term follow-up after macular hole surgery with internal limiting membrane peeling. Am J Ophthalmol 134:661–666
Hirata A, Yonemura N, Hasumura T, Murata Y, Negi A (2000) Effect of infusion air pressure on visual field defects after macular hole surgery. Am J Ophthalmol 130:611–616
Hutton WL, Fuller DG, Snyder WB, Fellman RL, Swanson WH (1996) Visual field defects after macular hole surgery. A new finding. Ophthalmology 103:2152–2158
Kerrison JB, Haller JA, Elman M, Miller NR (1996) Visual field loss following vitreous surgery. Arch Ophthalmol 114:564–569
Kurok AM, Kitaoka T, Taniguchi H, Amemiya T (2002) Hyperbaric oxygen therapy reduces visual field defect after macular hole surgery. Ophthalmic Surg Lasers 33:200–206
Lee MS, Rizzo JF 3rd, Lessell S (2002) Neuro-ophthalmologic complications of cataract surgery. Semin Ophthalmol 17:149–152
McCulley TJ, Lam BL, Feuer WJ (2003) Nonarteritic anterior ischemic optic neuropathy and surgery of the anterior segment: temporal relationship analysis. Am J Ophthalmol 136:1171–1172
McDonald HR, Verre WP, Aaberg TM (1986) Surgical management of idiopathic epiretinal membranes. Ophthalmology 93:978–983
Melberg NS, Thomas MA (1995) Visual field loss after pars plana vitrectomy with air/fluid exchange. Am J Ophthalmol 120:386–388
Oh KT, Boldt HC, Maturi RK, Folk JC, Kardon RH (2000) Evaluation of patients with visual field defects following macular hole surgery using multifocal electroretinography. Retina 20:238–243
Ohji M, Nao-I N, Saito Y, Hayashi A, Tano Y (1999) Prevention of visual field defect after macular hole surgery by passing air used for fluid-air exchange through water. Am J Ophthalmol 127:62–66
Paques M, Massin P, Santiago PY, Spielmann AC, Gaudric A (1997) Visual field loss after vitrectomy for full-thickness macular holes. Am J Ophthalmol 124:88–94
Pendergast SD, McCuen BW 2nd (1996) Visual field loss after macular hole surgery. Ophthalmology 103:1069–1077
Russell SR, Hageman GS (2001) Optic disc, foveal, and extrafoveal damage due to surgical separation of the vitreous. Arch Ophthalmol 119:1653–1658
Serrano LA, Behrens MM, Carroll FD (1982) Postcataract extraction ischemic optic neuropathy. Arch Ophthalmol 100:1177–1178
Takenaka H, Maeno T, Mano T, Mitsuda H (1999) Causes of visual field defects after vitrectomy. Nippon Ganka Gakkai Zasshi 103:399–403
Welch JC (1997) Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole. Am J Ophthalmol 124:698–699
Williams JM Sr, Jacobson DM (1997) Visual field loss after vitreous surgery. Arch Ophthalmol 115:434–435
Yan H, Dhurjon L, Chow DR, Williams D, Chen JC (1998) Visual field defect after pars plana vitrectomy. Ophthalmology 105:1612–1616
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Grant Support: Supported in part by an nnrestricted grant from Research to Prevent Blindness, New York, NY (MSL).
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Taban, M., Lewis, H. & Lee, M.S. Nonarteritic anterior ischemic optic neuropathy and ‘visual field defects’ following vitrectomy: could they be related?. Graefe's Arch Clin Exp Ophthalmol 245, 600–605 (2007). https://doi.org/10.1007/s00417-006-0420-5
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DOI: https://doi.org/10.1007/s00417-006-0420-5