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Changes of Pigment Epithelium after Operation of Idiopathic Macular Holes


Authors: I. Karel;  B. Kalvodová;  P. Kuthan;  Z. Dubská;  D. Dotřelová
Authors‘ workplace: Oční klinika 1. LF UK a VFN, Praha, přednosta, doc. MUDr. M. Filipec, CSc.
Published in: Čes. a slov. Oftal., , 2000, No. 4, p. 210-217
Category:

Overview

To evaluate changes of the retinal pigment epithelium (RPE) aftersurgery of an idiopathic macular holes (IMD) and their effect on visual acuity.Methods: Fifty eyes of 44 patients with IMD were subjected to pars plana vitrec-tomy, separation of the adhering cores of the vitreous body and IMD tamponadewith 16% C 3 F 8. In 32 eyes autologous thrombocyte concentrate (AKT) was admi-nistered, during the initial operation in 23 eyes and during re-operation in 9 eyes.The patients were followed up for 6-28 months (average 15 months).Changes of RPE were evaluated by biomicroscopy and fluoroangiography.Results: Changes of RPE were observed in 18 eyes (36 %). In this group visualacuity improved in 11 eyes (61 %) and the final mean visual acuity was 0.41.Facet-like foci characterized by minor defects and/or hyperplasia of RPE werefound in 27 eyes (54%). In this group visual acuity improved in 19 eyes (70 %) andthe final visual acuity, 0.22, and the mean difference between pre- and postopera-tive visual acuity were significantly worse than in the eyes without new changesof RPE (p = 0.0108, and 0.0470 resp.).Disciform (phototoxic) lesions in the maculadeveloped in five eyes (10 %) and were manifested by gross spotty changes of RPEon fluoroangiograms, as a rule by early hypofluorescence and late subretinalstaining. Visual acuity improved slightly on one eye (20 %). AKT did not affectchanges of RPE.Conclusions: Changes of RPE after operation of IMD are frequent and maysignificantly reduce the postoperative visual acuity. Administration of AKT du-ring surgery does not influence the incidence of RPE changes. RPE changes areprobably caused by surgical trauma of a compromised macula.

Key words:
idiopathic macular hole, pars plana vitrectomy, retinal pigment

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Ophthalmology
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