Abstract
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.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Kinoshita T, Imaizumi H, Okushiba U, Miyamoto H, Ogino T, Mitamura Y. Time course of changes in metamorphopsia, visual acuity, and OCT parameters after successful epiretinal membrane surgery. Invest Ophthalmol Vis Sci. 2012;53:3592–7.
Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Time course of changes in aniseikonia and foveal microstructure after vitrectomy for epiretinal membrane. Ophthalmology. 2014;121:2255–60.
Takabatake M, Higashide T, Udagawa S, Sugiyama K. Postoperative changes and prognostic factors of visual acuity, metamorphopsia, and aniseikonia after vitrectomy for epiretinal membrane. Retina. 2018;38:2118–27.
Uemura A, Kanda S, Sakamoto Y, Kita H. Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green–assisted internal limiting membrane peeling. Am J Ophthalmol. 2003;136:252–7.
Ripandelli G, Scarinci F, Piaggi P, Guidi G, Pileri M, Cupo G, et al. Macular pucker: to peel or not to peel the internal limiting membrane? A microperimetric response. Retina. 2015;35:498–507.
Azuma K, Ueta T, Eguchi S, Aihara M. Effects of internal limiting membrane peeling combined with removal of idiopathic epiretinal membrane: a systematic review of literature and meta-analysis. Retina. 2017;37:1813–9.
Asrani S, Essaid L, Alder BD, Santiago-Turla C. Artifacts in spectral-domain optical coherence tomography measurements in glaucoma. JAMA Ophthalmol. 2014;132:396–402.
Tham Y-C, Li X, Wong TY, Quigley HA, Aung T, Cheng C-Y. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90.
Traynis I, De Moraes CG, Raza AS, Liebmann JM, Ritch R, Hood DC. Prevalence and nature of early glaucomatous defects in the central 10° of the visual field. JAMA Ophthalmol. 2014;132:291–7.
Murata H, Hirasawa H, Aoyama Y, Sugisaki K, Araie M, Mayama C, et al. Identifying areas of the visual field important for quality of life in patients with glaucoma. PLoS ONE. 2013;8:1–7.
Moroi SE, Gottfredsdottir MS, Van Heck T, Musch DC, Johnson MW. Visual field results after vitreous surgery in a case series of patients with open-angle glaucoma. Ophthalmic Surg Lasers. 2000;31:380–6.
Tsuchiya S, Higashide T, Sugiyama K. Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes. PLoS ONE. 2017;12:e0177526.
Heijl A, Lindgren G, Olsson J. The effect of perimetric experience in normal subjects. Arch Ophthalmol. 1989;107:81–6.
Koseki N, Araie M, Yamagami J, Suzuki Y. Sectorization of central 10-deg visual field in open-angle glaucoma - An approach for its brief evaluation. Graefes Arch Clin Exp Ophthalmol. 1995;233:621–6.
De Moraes CG, Song C, Liebmann JM, Simonson JL, Furlanetto RL, Ritch R. Defining 10-2 visual field progression criteria: exploratory and confirmatory factor analysis using pointwise linear regression. Ophthalmology. 2014;121:741–9.
Hood DC, Raza AS, de Moraes CGV, Liebmann JM, Ritch R. Glaucomatous damage of the macula. Prog Retin Eye Res. 2013;32:1–21.
Hood DC, Anderson SC, Wall M, Kardon RH. Structure versus function in glaucoma: an application of a linear model. Invest Ophthalmol Vis Sci. 2007;48:3662–8.
Drasdo N, Millican CL, Katholi CR, Curcio CA. The length of Henle fibers in the human retina and a model of ganglion receptive field density in the visual field. Vis Res. 2007;47:2901–11.
Ohkubo S, Higashide T, Udagawa S, Sugiyama K, Hangai M, Yoshimura N, et al. Focal relationship between structure and function within the central 10 degrees in glaucoma. Invest Ophthalmol Vis Sci. 2014;55:5269–77.
Govetto A, Lalane RA, Sarraf D, Figueroa MS, Hubschman JP. Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme. Am J Ophthalmol. 2017;175:99–113.
Tadayoni R, Paques M, Massin P, Mouki-Benani S, Mikol J, Gaudric A. Dissociated optic nerve fiber layer appearance of the fundus after idiopathic epiretinal membrane removal. Ophthalmology. 2001;108:2279–83.
Araie M, Iwase A, Sugiyama K, Nakazawa T, Tomita G, Hangai M, et al. Determinants and characteristics of bruch’s membrane opening and bruch’s membrane opening–minimum rim width in a normal Japanese population. Invest Ophthalmol Vis Sci. 2017;58:4106–13.
Haritoglou C, Ehrt O, Gass CA, Kristin N, Kampik A. Paracentral scotomata: a new finding after vitrectomy for idiopathic macular hole. Br J Ophthalmol. 2001;85:231–3.
Ooto S, Hangai M, Tomidokoro A, Saito H, Araie M, Otani T, et al. Effects of age, sex, and axial length on the three-dimensional profile of normal macular layer structures. Invest Ophthalmol Vis Sci. 2011;52:8769–79.
Baba T, Hagiwara A, Sato E, Arai M, Oshitari T, Yamamoto S. Comparison of vitrectomy with brilliant blue G or indocyanine green on retinal microstructure and function of eyes with macular hole. Ophthalmology. 2012;119:2609–15.
Tari SR, Vidne-Hay O, Greenstein VC, Barile GR, Hood DC, Chang S. Functional and structural measurements for the assessment of internal limiting membrane peeling in idiopathic macular pucker. Retina. 2007;27:567–72.
Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M. Double staining with brilliant blue G and double peeling for epiretinal membranes. Ophthalmology. 2009;116:1370–6.
Park SUNHO, Kim YJ, Lee SJIN. Incidence of and risk factors for dissociated optic nerve fiber layer after epiretinal membrane surgery. Retina. 2013;36:1–5.
Alkabes M, Salinas C, Vitale L, Burés-Jelstrup A, Nucci P, Mateo C. En face optical coherence tomography of inner retinal defects after internal limiting membrane peeling for idiopathic macular hole. Invest Ophthalmol Vis Sci. 2011;52:8349–55.
Mitamura Y, Ohtsuka K. Relationship of dissociated optic nerve fiber layer appearance to internal limiting membrane peeling. Ophthalmology. 2005;112:1766–70.
Ito Y, Terasaki H, Takahashi A, Yamakoshi T, Kondo M, Nakamura M. Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes. Ophthalmology. 2005;112:1415–20.
Nukada K, Hangai M, Ooto S, Yoshikawa M, Yoshimura N Jr, BH, et al. Tomographic features of macula after successful macular hole surgery. Invest Ophthalmol Vis Sci. 2013;54:2417–28.
Govetto A, Virgili G, Rodriguez FJ, Figueroa MS, Sarraf D, Hubschman JP. Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: surgical results at 12 months. Retina. 2019;39:347–57.
Terashima H, Okamoto F, Hasebe H, Matsuoka N, Fukuchi T. Vitrectomy for epiretinal membranes: ganglion cell features correlate with visual function outcomes. Ophthalmol Retin. 2018;2:1152–62.
Castro DPE, Kawase J, Melo LAS. Learning effect of standard automated perimetry in healthy individuals. Arq Bras Oftalmol. 2008;71:523–8.
De Moraes CG, Liebmann JM, Levin LA. Detection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma. Prog Retin Eye Res. 2017;56:107–47.
Acknowledgements
The authors thank Shiroaki Shirato M.D. for his helpful advice on the 10-2 VF sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tsuchiya, S., Higashide, T., Udagawa, S. et al. Glaucoma-related central visual field deterioration after vitrectomy for epiretinal membrane: topographic characteristics and risk factors. Eye 35, 919–928 (2021). https://doi.org/10.1038/s41433-020-0996-8
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-020-0996-8
This article is cited by
-
Effect of membrane peeling on the ganglion cell inner-plexiform layer in glaucomatous eyes with idiopathic epiretinal membrane
Graefe's Archive for Clinical and Experimental Ophthalmology (2026)
-
Premacular membranes and glaucoma: a review of clinical and therapeutic considerations
Graefe's Archive for Clinical and Experimental Ophthalmology (2025)
-
Correlation between internal limiting membrane preservation and sub-epiretinal membrane space during epiretinal membrane surgery
Japanese Journal of Ophthalmology (2025)
-
Increased late-onset glaucoma risk following vitrectomy for macular pucker or hole
Eye (2024)
-
Long-term risk factors for poor visual outcomes in patients with epiretinal membrane and open-angle glaucoma: a retrospective study
Scientific Reports (2024)
