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

      The British Journal of Ophthalmology

      Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Ophthalmoscopy, methods, Retinal Perforations, surgery, Scotoma, diagnosis, etiology, Visual Field Tests, Vitrectomy, adverse effects

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          To report the occurrence of paracentral scotomata after pars plana vitrectomy for idiopathic macular holes. 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 degrees (Goldmann II), employed intensity 0 and 12 dB, 20 degrees fields in all tests). Surgery consisted of standard three port vitrectomy including removal of epiretinal membranes and the inner limiting membrane. 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 degrees to 4.0 degrees (360-1200 microm), smallest dimension from 0.25 degrees to 2.0 degrees (75-600 microm). In three patients more than one scotoma was observed. 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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