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Influence of vitrectomy on the progression of dry age-related macular degeneration

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To demonstrate whether pars plana vitrectomy (PPV) changes the progression of dry age-related macular degeneration (AMD) by assessing longitudinal changes in drusen volume over follow-up.

Methods

Dry AMD patients who had undergone unilateral PPV for symptomatic vitreomacular disorders were evaluated for the progression of disease by spectral domain-optical coherence tomography (SD-OCT) features including drusen volume, development of geographic atrophy, or choroidal neovascularization during follow-up. Drusen volume was manually calculated using an image processing software (ImageJ, NIH) on raster SD-OCT scans. Mean change in drusen volume of surgery eyes was compared with values of the fellow eyes of the same subjects (control group).

Results

Among 183 eyes with both vitreoretinal disorder and dry AMD, 48 eyes of 24 patients met the inclusion criteria and were included. The mean drusen volume change during a mean of 25.49 ± 23.35 months of follow-up (range: 6.00–86.87 months) was 4.236.899 ± 20.488.913 μm3 in the study eye and 7.796.357 ± 34.798.519 μm3 in the fellow eye (p = 0.297). Best-corrected visual acuity (BCVA) significantly increased from 0.40 ± 0.18 logMAR (≈ 20/50 Snellen equivalent) to 0.32 ± 0.31 (≈ 20/41 Snellen equivalent) after surgery (p = 0.012) in the study group while BCVA remained stable in the control group (0.19 ± 0.34 logMAR [≈ 20/30 Snellen equivalent] at baseline and 0.20 ± 0.31 logMAR [≈ 20/31 Snellen equivalent], p = 0.432). Choroidal neovascularization developed in 1 vitrectomized eye (4.54%) and in 1 eye (4.54%) from the control group during follow-up.

Conclusion

Vitrectomy did not seem to worsen dry AMD progression; even more visual acuity may improve despite a slight increase in drusen volume following surgery.

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Funding

This research is supported in part by NIH grant R01 EY016323-09A1 (D.U.B.), a core grant from the National Eye Institute P30 EY022589, and an unrestricted grant from Research to Prevent Blindness, NY (WRF).

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Authors and Affiliations

  1. Department of Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA

    Ilkay Kilic Muftuoglu, Tiezhu Lin, Dirk-Uwe Bartsch & William R. Freeman

  2. Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey

    Ilkay Kilic Muftuoglu

  3. He Eye Specialists Hospital, He University, Shenyang, Liaoning Province, China

    Tiezhu Lin

Authors
  1. Ilkay Kilic Muftuoglu
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  2. Tiezhu Lin
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  3. Dirk-Uwe Bartsch
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  4. William R. Freeman
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Corresponding author

Correspondence to William R. Freeman.

Ethics declarations

The University of California, San Diego Institutional Review Board approval was acquired for the review and analysis of patients’ medical records. The study adhered to the tenets of the Declaration of Helsinki for research involving human subjects and complied with Health Insurance Portability and Accountability Act (HIPAA) regulations.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Muftuoglu, I.K., Lin, T., Bartsch, DU. et al. Influence of vitrectomy on the progression of dry age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 259, 847–853 (2021). https://doi.org/10.1007/s00417-020-04943-x

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  • DOI: https://doi.org/10.1007/s00417-020-04943-x

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