Cataract surgery in eyes with adult-onset foveomacular-vitelliform dystrophy

To assess the outcomes and safety of cataract surgery in Adult-Onset Foveomacular-Vitelliform dystrophy (AFVD) patients.

This retrospective study analyzed eyes with AFVD that underwent cataract surgery in a tertiary center, comparing them with eyes affected by none and neovascular age-related macular degeneration (NVAMD). Data included demographics, best-corrected visual acuity LogMAR (VA), eye examination results, and optical coherence tomography (OCT) results. The primary outcome was improvement in VA. A secondary outcome was AFVD progression such as the development of choroidal neovascularization (CNV) or retinal atrophy.

The cohort included 83 eyes (18 with AFVD, 27 with none-NV AMD, and 38 with NVAMD). AFVD eyes showed significant improvement in VA±SD from pre-surgery (0.60 ± 0.34) to 1 month (0.23 ± 0.11; P < 0.0001) and 12 months post-operatively (0.26 ± 0.12; P < 0.0001). No cases of CNV or major AFVD progression changes were observed over 12 months of follow up. However, at last follow-up (62.20 ± 39.30 months) there was increased proportion of atrophic AFVD (44.40% compared to 5.50% at baseline; P = 0.10). No difference was found comparing VA improvement one month after surgery of none-NV AMD, NVAMD and AFVD (AFVD = 0.37 ± 0.36, none-NV AMD = 0.47 ± 0.68, NVAMD = 0.28 ± 0.37; P = 0.29). In the none-NV AMD group, one eye developed CNV ten months post-operatively and another eye demonstrated worsening retinal atrophy one-month post-surgery. In the NVAMD group, 9 eyes developed retinal atrophy at last follow up.

Cataract surgery in AFVD eyes led to significant visual acuity improvement and demonstrated good safety with no new CNV or retinal atrophy. The similar visual improvement across the AFVD, none-NV AMD and NVAMD groups suggests the procedure's efficacy and safety for AFVD patients.