Cambios maculares y de capa de fibras nerviosas ganglionares posterior a la vitrectomía pars plana y sus factores pronósticos en la fundación oftalmológica nacional
Thesis
PURPOSE: To determine prognostic factors, macular morphology and nerve fiber ganglion layer changes after pars plana vitrectomy, at Fundación Oftalmológica Nacional.DESIGN AND METHODS: Longitudinal trial, before and after pars plana vitrectomy (3 and 6 months) involving patients with epiretinal membrane, macular hole, macular vitreous traction syndrome and noninflammatory vitreous opacities. Clinical and optic coherence tomography monitoring was done.RESULTS: Sixty patients (65.0% women), with average age of 65.45+9.49 years, and mean disease duration of 23+29.79months. The indications for pars plana vitrectomy (n=60eyes) were macular hole (38.3%) and epiretinal membrane (36.7%). Significant difference was observed in the thickness of ganglion cell layer (GCL)+inner plexiform layer (IPL) complex at baseline and third months (p=0.039), correlation between GCL + IPL complex at third and sixth months (r=0.704,p<0.001) and GCL + IPL complex at third month with central foveal thickness (CFT) at third and sixth months (r=–0.594,p<0.001 and r=–0.595,p=0.001). Patients older than 65 years have less GCL thickness at six months (r=-0.528,p=0.007). GCFL average thickness and the presence of ellipsoid layer were baseline predictors of good visual acuity after pars plana vitrectomy (r2=0.414,p=0.018, and r2=0.414,p=0.010).CONCLUSION: GNFL thickness and the presence of the ellipsoid zone at baseline are highly predictive of good visual acuity at the third postoperative month of pars plana vitrectomy and there is an inverse correlation between GCL + IPL complex with CFT at third and sixth months after pars plana vitrectomy.
