RISK FACTORS AND PREDICTIVE CUTOFF VALUES FOR NEW-ONSET MICROSCOTOMA AFTER VITRECTOMY WITH INTERNAL LIMITING MEMBRANE...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Visual Electrophysiology

Background:

• Epiretinal membrane (ERM) surgery often involves internal limiting membrane (ILM) peeling.
• Postoperative microscotoma can affect visual function after ILM peeling.
• Identifying risk factors is crucial for improving surgical outcomes.

Purpose of the Study:

• To determine risk factors for new-onset microscotoma following vitrectomy with ERM and ILM peeling.
• To establish predictive cutoff values for identifying eyes at risk of microscotoma.
• To guide strategies for preventing postoperative visual field defects.

Main Methods:

• Retrospective analysis of 174 patients undergoing vitrectomy with ERM and ILM peeling.
• Evaluation of visual acuity, metamorphopsia, and visual field (Humphrey Field Analyzer 10-2) preoperatively and postoperatively.
• Definition of new-onset microscotoma based on changes in visual field sensitivity (dB).

Main Results:

• New-onset microscotoma occurred in 17.8% of eyes.
• Significant risk factors included glaucoma, secondary ERM, indocyanine green use, and male sex.
• Predictive cutoff values were identified, with high negative predictive values (>99%) for low-risk areas.

Conclusions:

• Glaucoma, secondary ERM, ICG use, and male sex are key risk factors for postoperative microscotoma.
• Established cutoff values and identified vulnerable macular regions (temporal, inferior) aid in risk stratification.
• Findings support optimizing ILM peeling techniques and preoperative patient counseling to minimize microscotoma risk.