Effect of preoperative retinal sensitivity and fixation on long-term prognosis for idiopathic macular holes
- 309 Downloads
To study the roles of preoperative retinal sensitivity and fixation exams in predicting the long-term prognosis of idiopathic macular hole (IMH) patients after successful vitrectomy.
A total of 39 IMH patients (39 eyes) were included in this prospective cohort case series study. Twenty-three gauge pars plana vitrectomy was performed on each patient. Results of best-corrected visual acuity (BCVA), macular hole diameter, MP − 1 microperimetry (MP − 1) tests, and continuity of the photoreceptor inner and outer segment (IS/OS) junction were recorded for analysis.
Postoperative BCVA at 12 months was significantly correlated with macular hole diameters (p < 0.05), preoperative BCVA (p = 0.020), mean retinal sensitivity (p < 0.001), and fixation location percentage (p < 0.001). However, merely preoperative mean retinal sensitivity (r = 0.5448, p < 0.001) and fixation location percentage (r = 0.5624, p < 0.001) were suggested to be quantitatively predictive for the visual prognosis by multiple stepwise linear regression analysis. Moreover, patients that had smaller hole sizes (p < 0.01), better mean retinal sensitivity (p = 0.003), higher fixation quality scores, and higher fixation location percentage (p = 0.008) before surgery were prone to get continuous IS/OS junction 12 months after surgery.
MP-1 exams evaluate the dysfunctional hole margin and thus provide more comprehensive information of the preoperative visual function of IMH patients. Both mean retinal sensitivity and fixation behaviors are ideal measurements in predicting the prognosis after successful macular hole surgery.
KeywordsIdiopathic macular hole (IMH) Best-corrected visual acuity (BCVA) The MP-1 microperimetry Visual prognosis Photoreceptor inner and outer segment (IS/OS) junction
The author(s) have no proprietary or commercial interests in any materials discussed in this article.
This study was supported by grant G.Z.X./No. 2007CB512205 from the Ministry of Science and Technology of the People’s Republic of China, by grant G.Z.X./No. 09XD1400900 from the Science and Technology commission of Shanghai Municipality, by grant G.Z.X./No. 30872825 from National Natural Science Foundation of China, and by grant D.G./No. 30801267 from National Natural Science Foundation of China.
Contributions of authors
Involved in conception and design of study (Z.S., D.G., C.J., G.X.); Analysis and interpretation of data (Z.S., D.G., C.J., M.W.); Writing the article (G.X., Z.S.); Critical revision of the article (G.X., A.S., A.C.J.); Final approval of the article (Z.S., D.G., G.X.); Data collection (Z.S.); Patients referring (G.X.); Statistical expertise (Z.S.); Obtaining funding (G.X., D.G.); and Literature search (Z.S., D.G.).
Approval for data collection and analysis was obtained from the Institutional Review Board of Eye and ENT Hospital of Fudan University (NO. KJ2009-16).
- 4.Grigoropoulos VG, Theodossiadis GP, Theodossiadis PG Association of the preoperative photoreceptor layer defect as assessed by optical coherence tomography with the functional outcome after macular hole closure: a long follow-up study. Ophthalmologica 225:47–54Google Scholar
- 6.Passemard M, Yakoubi Y, Muselier A, Hubert I, Guillaubey A, Bron AM, Berrod JP, Creuzot-Garcher C Long-term outcome of idiopathic macular hole surgery. Am J Ophthalmol 149:120–126Google Scholar
- 15.Freeman WR, Azen SP, Kim JW, El-Haig W, Mishell DR 3rd, Bailey I (1997) Vitrectomy for the treatment of full-thickness stage 3 or 4 macular holes. Results of a multicentered randomized clinical trial. The Vitrectomy for Treatment of Macular Hole Study Group. Arch Ophthalmol 115:11–21PubMedCrossRefGoogle Scholar
- 22.Ozdemir H, Karacorlu M, Senturk F, Karacorlu SA, Uysal O (2010) Retinal sensitivity and fixation changes 1 year after triamcinolone acetonide assisted internal limiting membrane peeling for macular hole surgery—a MP-1 microperimetric study. Acta Ophthalmol 88:e222–227Google Scholar
- 24.Sano M, Shimoda Y, Hashimoto H, Kishi S (2009) Restored photoreceptor outer segment and visual recovery after macular hole closure. Am J Ophthalmol 147(313–318):e311Google Scholar