Reading Speed as an Objective Measure of Improvement Following Vitrectomy for Symptomatic Vitreous Opacities

Abstract

Background and Objective: There is currently no objective measure of the visual deficits experienced by patients with symptomatic vitreous opacities (SVO) that would also correlate with the functional improvement they report following vitrectomy. This study aims to determine whether reading speed can be used as a reliable outcome measure to assess objectively the impact of both SVO and vitrectomy on patients' visual performance. Study Design/Materials and Methods: 20 adult patients seeking surgery for SVO were included. Measures of visual function were obtained before and after vitrectomy using the ETDRS acuity chart, the NEI-VFQ and the MNREAD. Results: In patients with non-opacified lenses (N=10), maximum reading speed increased significantly from 138 to 159 words per minute after complete removal of SVO by vitrectomy (95%CI = [14, 29], p < 0.001). Conclusion: Reading speed is impaired with SVO, and improves following vitrectomy in phakic and pseudophakic eyes with clear lenses. Reading speed is a valid objective measure to assess the positive effect of vitrectomy for SVO on near-distance daily life activities.

Current treatment strategies for symptomatic vitreous opacities

“…Ryan et al recorded scanning laser ophthalmoscopy (SLO) images of vitreous in static and dynamic fashion, and the findings were graded by masked observers (Supplemental Digital Content http://links.lww.com/COOP/A40 – Ryan SDC2 – SLO video demonstrating symptomatic vitreous opacities http://links.lww.com/COOP/A41). All patients had marked improvement in SLO appearance, but the severity grade of opacities did not correlate to VFQ-25 score improvement [10 ▪ ].…”

“…There was an improvement postoperatively of 19.3% in the composite score, 28.13% in general vision, and 27.37% in near activities. Ryan et al used the VFQ-25 and found an average score change of 17.8 points overall, and 21.1 points in near activities subscores [10 ▪ ]. Schultz-Key used a modified 12-question survey, and found that 88% of patients were satisfied with the results of the operation, and 73% felt that their vision was either better or much better following surgery [2].…”

“…In a prospective study using MNREAD (name of the minnesota low-vision reading charts) to assess changes in formal reading speed postvitrectomy for symptomatic vitreous opacities, maximum reading speed increased from 138 to 159 words per minute postsurgery ( P < 0.001). VFQ-25 scores also improved 26% on average following vitrectomy [10 ▪ ]. For context, VFQ-25 score improvement in the ANCHOR (anti-VEGF antibody for the treatment of predominantly classic choroidal neovascularization in age-related macular degeneration) and MARINA (minimally classic/occult trial of the anti-VEGF antibody ranibizumab in the treatment of neovascular age-related macular degeneration) phase 3 age-related macular degeneration (AMD) clinical trials averaged around 7% [12].…”

Visualization and Grading of Vitreous Floaters Using Dynamic Ultra-Widefield Infrared Confocal Scanning Laser Ophthalmoscopy: A Pilot Study

“…However, a survey conducted on patients with floaters showed that they were willing to trade off an average of 1.1 years out of every 10 years of their remaining life to get rid of the symptoms associated with floaters, and were also willing to take a 7% risk of blindness and 11% of death to get rid of symptoms associated with floaters [ 18 ]. Additionally, several studies have reported significant improvement in symptoms [ 16 ], patient satisfaction [ 17 ], quality of life [ 19 , 20 ] and reading speed [ 20 ] after vitrectomy for the removal of vitreous floaters.…”