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

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.