Changes in Contrast Sensitivity after Surgery for Macula-On Rhegmatogenous Retinal Detachment

Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. Electronic address: .
American Journal of Ophthalmology (Impact Factor: 3.87). 07/2013; 156(4). DOI: 10.1016/j.ajo.2013.05.017
Source: PubMed


To evaluate changes in contrast sensitivity after surgery for macula-on rhegmatogenous retinal detachment (RRD).
Prospective, interventional, consecutive, case-control study.
This study included 84 eyes of 84 patients with unilateral macula-on RRD undergoing primary scleral buckling or vitrectomy without postoperative macular complication. We examined the logarithm of the minimal angle of resolution best-corrected visual acuity (logMAR BCVA) and contrast sensitivity at 4 spatial frequencies (3, 6, 12, and 18 cycles/degree) using the CSV-1000E (Vector Vision) before and after surgery. From the data obtained with the CSV-1000E, the area under the log contrast sensitivity function was calculated. The logMAR BCVA and contrast sensitivity in the contralateral normal eyes also were measured and were used as normal controls. Clinical data were collected, including age, gender, surgical procedures, the number of retinal tears, circumferential dimension of retinal tears, and area of retinal detachment, to determine the clinical factors related to visual function.
Preoperative contrast sensitivity was significantly worse in eyes with RRD than in normal controls, but the preoperative logMAR BCVA was not different from that of normal controls. Contrast sensitivity decreased significantly after surgery, but logMAR BCVA did not change by surgery. Multiple regression analysis revealed that postoperative contrast sensitivity had a significant correlation with the circumferential dimension of retinal tears, whereas no clinical parameters were associated significantly with postoperative BCVA.
Surgery for macula-on RRD did not change visual acuity, whereas contrast sensitivity was affected significantly in association with the extent of retinal tears.

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    ABSTRACT: Purpose: To evaluate contrast sensitivity (CS) in patients with epiretinal membrane (ERM) following vitrectomy and to investigate the relationship between CS and foveal microstructures with spectral-domain optical coherence tomography (SD-OCT). Methods: Thirty-one eyes of 31 patients with ERM were included. We examined CS with a CSV-1000E chart, a logMAR best-corrected visual acuity (BCVA), and foveal microstructure by using SD-OCT before and at 6 months after surgery. From the CS data, the area under the log contrast sensitivity function (AULCSF) was calculated. Based on the OCT images, we quantified the mean thickness of the ganglion cell layer (GCL), the inner nuclear layer (INL), and the outer retinal layer (outer nuclear layer and outer plexiform layer [ONL+OPL]). The status of the photoreceptor inner and outer segment junction (IS/OS) and external limiting membrane (ELM) was also evaluated. Results: Vitrectomy significantly improved logMAR BCVA and AULCSF. Even in patients with poor improvement of visual acuity (changes in logMAR BCVA by surgery was ≤0.2), postoperative AULCSF significantly increased by treatment (P < 0.05). Postoperative AULCSF showed a significant correlation with preoperative (P < 0.05) and postoperative (P < 0.05) ONL+OPL thickness, whereas other parameters were not relevant. Postoperative logMAR BCVA significantly correlated with postoperative status of IS/OS (P < 0.05) and preoperative ONL+OPL thickness (P < 0.05). Conclusions: In patients with ERM, CS improved even though their visual acuity did not recover significantly by vitrectomy. CS was associated with the thickness of outer retinal layer.
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