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Pre- and postoperative microperimetry in patients with epiretinal membrane and macular hole

Prä- und postoperative Mikroperimetrie bei Patient*innen mit epiretinaler Membran und Makulaforamen

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Summary

Background

Part of multimodal imaging in patients with macular hole and epiretinal membrane is often microperimetry, a method to measure the central sensitivity of the retina. A study by Richter-Mueksch et al. with the microperimeter MP‑1 (Nidek Technologies Srl, Vigonza, Italy) reported that visual acuity alone underestimates the benefit of surgery and that more patients show improvement in microperimetry postoperatively. The aim of this study was to confirm these results with the microperimeter MP‑3 (Nidek Co., LTD., Aichi, Japan) currently in use at our institution.

Methods

A retrospective data analysis was performed of patients who underwent surgery for epiretinal membrane or macular hole from January 2020 to December 2022 and who underwent pre- and postoperative microperimetry.

Results

Overall, 18 patients who underwent microperimetry pre- and postoperatively were included in this analysis. The mean age was 71 years and 67% of the patients were female. Five patients had surgery due to macular hole and 13 patients due to epiretinal membrane. There was a significant increase in visual acuity postoperatively (p = 0.01, z = −2.57, r = −0.61). The median visual acuity was 0.4 logMAR preoperatively and 0.2 logMAR postoperatively. Total mean retinal sensitivity showed no statistically significant change; however, the central mean retinal sensitivity within a 4° fixation point circle showed significant improvement postoperatively (p = 0.04, z = 2.84, r = 0.67).

Conclusion

In summary, there was a significant improvement in visual acuity postoperatively, but only a significant increase in retinal sensitivity centrally, whereas overall retinal sensitivity did not show a statistically significant increase.

Zusammenfassung

Hintergrund

Teil der multimodalen Bildgebung bei Patient*innen mit Makulaforamen und epiretinaler Membran (ERM) ist oft die Mikroperimetrie, eine Methode, um die zentrale Sensitivität der Retina zu messen. Richter-Mueksch et al. zeigten in einer Studie mit dem Mikroperimeter MP‑1 (Nidek Technologies Srl, Vigonza, Italien), dass mit der alleinigen Visusbestimmung der Nutzen einer Operation unterschätzt wird und mehr Patient*innen postoperativ eine Verbesserung in der Mikroperimetrie aufweisen. Ziel der Studie war es, diese Ergebnisse mit dem aktuell an der Abteilung der Autoren in Verwendung befindlichen Mikroperimeter MP‑3 (Nidek Co., LTD., Aichi, Japan) zu bestätigen.

Methoden

Eine retrospektive Datenanalyse erfolgte an Patient*innen, die von Januar 2020 bis Dezember 2022 aufgrund einer epiretinalen Membran bzw. eines Makulaforamens operiert worden sind und bei denen eine prä- und postoperative Mikroperimetrie durchgeführt wurde.

Ergebnisse

In die Studie wurden 18 Patient*innen, bei denen prä- und postoperativ eine Mikroperimetrie erfolgte, eingeschlossen. Das mittlere Alter betrug 71 Jahre, 67 % der Patient*innen waren weiblich. Aufgrund eines Makulaforamens wurden 5, aufgrund einer ERM 13 Patient*innen operiert. Es zeigte sich postoperativ ein signifikanter Anstieg des Visus (p = 0,01; z = −2,57; r = −0,61). Der mediane Visus betrug präoperativ 0,4 logMAR und postoperativ 0,2 logMAR. Die gesamte mittlere retinale Sensitivität zeigte keine statistisch signifikante Veränderung, während die zentrale mittlere retinale Sensitivität in einem 4°-Fixationsradius postoperativ eine signifikante Verbesserung aufwies (p = 0,04; z = 2,84; r = 0,67).

Schlussfolgerung

Zusammenfassend zeigte sich postoperativ eine signifikante Visusverbesserung, ein signifikanter Anstieg der retinalen Sensitivität fand sich jedoch nur zentral, während die retinale Sensitivität insgesamt keinen statistisch signifikanten Anstieg aufwies.

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Authors and Affiliations

  1. Klinik Hietzing, Augenabteilung, Wiener Gesundheitsverbund, Wolkersbergenstraße 1, 1130, Vienna, Austria

    Sarah N. Mehany,  Birgit Weingessel HCM MBA &  Veronika Vécsei-Marlovits MSc, MBA

  2. Karl Landsteiner Institut für Prozessoptimierung und Qualitätsmanagement in der Katarakt-Chirurgie, Karl Landsteiner Gesellschaft, Wolkersbergenstraße 1, 1130, Vienna, Austria

    Sarah N. Mehany,  Birgit Weingessel HCM MBA &  Veronika Vécsei-Marlovits MSc, MBA

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Correspondence to Birgit Weingessel HCM MBA.

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S.N. Mehany, B. Weingessel and V. Vécsei-Marlovits declare that they have no competing interests.

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Mehany, S.N., Weingessel, B. & Vécsei-Marlovits, V. Pre- and postoperative microperimetry in patients with epiretinal membrane and macular hole. Spektrum Augenheilkd. (2024). https://doi.org/10.1007/s00717-024-00568-1

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