J Korean Ophthalmol Soc > Volume 52(3); 2011 > Article
Journal of the Korean Ophthalmological Society 2011;52(3):378-384.
DOI: https://doi.org/10.3341/jkos.2011.52.3.378    Published online March 15, 2011.
Visual Field Defect Developed after Internal Limiting Membrane Peeling in a Patient with Epiretinal Membrane.
Kyong Ho Kim, Ji Woong Lee, Ji Eun Lee, Boo Sup Oum
Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea. alertlee@hanmail.net
황반부 망막전막 환자에서 내경계막 제거 후 발생한 시야 결손
Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
To report a case of visual field defect developed after internal limiting membrane (ILM) peeling in a patient with macular epiretinal membrane (ERM). CASE SUMMARY: A 33-year-old female without a history of specific diseases presented with a gradually decreased visual acuity in the right eye for 3 years. The patient was diagnosed as having macular ERM and underwent vitrectomy. During ILM peeling, retinal hemorrhage occurred in the superior region of macula, which spontaneously disappeared 2 weeks after surgery. Transmission electron microscopy showed Muller cell end feet with damaged appearance adherent to the ILM. At 3 months after surgery, the patient developed retinal nerve fiber layer (RNFL) defect in the area where the spot retinal hemorrhage had occurred. Optical coherence tomography showed focal RNFL thinning in the superotemporal region. The automated perimetry revealed corresponding inferior nasal step and scotomas in the right eye. Intraocular pressure was normal throughout the follow-up period and there was no evidence of glaucomatous optic disc change. CONCLUSIONS: The results obtained from the patient in the present study indicated that visual field defect may be the result of a mechanical damage to the RNFL during ILM peeling.
Key Words: Internal limiting membrane peeling;Retinal nerve fiber layer defect;Visual field defect

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