Glaucoma-related central visual field deterioration after vitrectomy for epiretinal membrane: topographic characteristics and risk factors

Background/Objectives To identify risk factors for glaucoma-related central visual field (VF) deterioration after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM). Subjects/Methods A prospective cohort study consisting of cases with or without glaucoma (33 eyes of 33 patients in each group) who underwent vitrectomy with ILM peeling for ERM. Humphrey 10-2 VFs and ganglion cell complex (GCC) thickness were measured at baseline and about 3, 6, and 12 months postoperatively. Longitudinal changes in VF indices and factors associated with their postoperative changes were investigated using mixed-effects models, as was sectorwise total deviation (TD) analysis using six sectors consisting of outer/inner arcuate and cecocentral sectors in each hemifield. Results VF mean deviation significantly deteriorated postoperatively only in the glaucoma group (P < 0.001). Older age, longer axial length, preoperative worse mean deviation, and thinner GCC were significant risk factors for postoperative deterioration (coefficient +/- standard errors: -0.139 +/- 0.067, -0.740 +/- 0.241, 0.16 +/- 0.07, 0.050 +/- 0.020;P = 0.038,P = 0.002,P = 0.024,P = 0.012, respectively). Sectorwise analysis revealed that TD in the superior/inferior outer arcuate sectors significantly deteriorated only in the glaucoma group. Preoperative worse TD and thinner GCC were significant risk factors for deterioration in the superior outer arcuate sector (0.65 +/- 0.11, 0.08 +/- 0.03;P < 0.001,P = 0.042, respectively). Conclusions Central VF deterioration, especially in the outer arcuate sectors, found to be glaucoma-related changes after vitrectomy with ILM peeling for ERM. Preoperative worse VF and thinner GCC were identified as risk factors for postoperative VF deterioration.

Automated summary

Glaucoma-related central visual field deterioration was found to be more significant in patients who underwent vitrectomy with internal limiting membrane peeling for epiretinal membrane. Older age, longer axial length, worse mean deviation preoperatively, and thinner ganglion cell complex were identified as significant risk factors for postoperative deterioration.