Vitrectomy with macular peeling in eyes with vitreomacular interface disorders and nonexudative age-related macular degeneration

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BACKGROUND: The aim of the study was to assess the outcomes of pars plana vitrectomy and macular peeling for vitreomacular interface disorders in eyes with coexisting nonexudative age-related macular degeneration (AMD), and to compare the rate of AMD progression in operated and fellow eyes. METHODS: This retrospective comparative study included patients with bilateral nonexudative AMD and unilateral vitreomacular interface disorder who underwent pars plana vitrectomy with internal limiting membrane peeling. Controlateral unoperated eyes were used as a control group. Cox proportional hazards regression analysis was used to compare the incidence of macular neovascularization, geographic atrophy and progression to late AMD in operated eyes and fellow eyes. RESULTS: 142 eyes of 71 patients were included. The mean follow-up duration was 17.5 ± 15.5 months. Best corrected visual acuity significantly improved in operated eyes (from 0.47 ± 0.25 to 0.21 ± 0.18 logMAR; p < 0.001), while no significant difference was observed in fellow eyes (from 0.18 ± 0.22 to 0.33 ± 0.56 logMAR; p = 0.055). Central retinal thickness improved in operated eyes (from 0402.9 ± 79.9 to 296.1 ± 48.4 µm; p < 0.001), while no change in fellow eyes was observed (from 296.1 ± 48.4 to 312.7 ± 110.6 µm; p = 0.205). Vitrectomy was not associated with the risk of developing macular neovascularization (hazard ratio [HR] = 0.30; 95% confidence intervals (CI) = 0.08-1.09; p = 0.068); geographic atrophy (HR = 1.01, 95% CI = 0.32-3.12; p = 0.990) nor progression to late AMD (HR = 0.64, 95% CI = 0.28-1.49; p = 0.307). CONCLUSIONS: Pars plana vitrectomy with macular peeling for vitreomacular interface disorders in eyes with coexisting nonexudative AMD is associated with positive visual and functional outcomes, with no shot-term increased risk of AMD progression.

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