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. 2001 Feb;85(2):231–233. doi: 10.1136/bjo.85.2.231

Paracentral scotomata: a new finding after vitrectomy for idiopathic macular hole

C Haritoglou 1, O Ehrt 1, C Gass 1, N Kristin 1, A Kampik 1
PMCID: PMC1723828  PMID: 11159494

Abstract

AIMS—To report the occurrence of paracentral scotomata after pars plana vitrectomy for idiopathic macular holes.
METHODS—In 15 patients static microperimetry using a Rodenstock scanning laser ophthalmoscope (SLO-105) was performed preoperatively and 6 or 12 weeks postoperatively (stimulus size 0.2° (Goldmann II), employed intensity 0 and 12 dB, 20° fields in all tests). Surgery consisted of standard three port vitrectomy including removal of epiretinal membranes and the inner limiting membrane.
RESULTS—Postoperative paracentral scotomata were detected in areas that were tested normally before surgery. They were mostly located temporally and/or inferiorly and often appeared like nerve fibre bundle defects. The greatest dimension varied from 1.2° to 4.0° (360-1200 µm), smallest dimension from 0.25° to 2.0° (75-600 µm). In three patients more than one scotoma was observed.
CONCLUSION—Small, mostly asymptomatic, paracentral scotomata as a complication after vitrectomy for idiopathic macular hole have not been reported in the literature so far. Whether they are caused by trauma to the nerve fibres during surgery or other factors remains unknown.



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Figure 1  .

Figure 1  

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(A) Preoperative and postoperative (B) microperimetry of a left eye. White squares represent stimuli that were seen by the patient, black squares represent relative (12 dB) or deep (0 dB) scotomata. The white circle marks the area of the preoperative macular defect, the broken circle the area of the preoperative neurosensory detachment. Postoperatively a large deep scotoma inferior to the closed macular hole can be seen in an area that was tested normally before surgery. The scotoma had the shape of a nerve fibre bundle defect.

Figure 2  .

Figure 2  

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(A, B) Preoperative and postoperative (C) microperimetry of a left eye. Preoperatively a deep scotoma in the macular hole area is seen (A),which is surrounded by a relative scotoma (B). Postoperatively a large deep scotoma with irregular boundaries was found temporal to the area of the closed macular hole (C).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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