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T. Fiore, B. Iaccheri, C. Cagini, L. Biondi, F. Florio, F. Pietrolucci, F. Giansanti, P. Lavorato; Correlation of Functional Mapping, Optical Coherence Tomography and Autofluorescence in Macular Holes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4107.
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© ARVO (1962-2015); The Authors (2016-present)
To correlate in patients with idiopathic macular hole (MH), lamellar MH and macular pseudohole the morphologic appearance of the macula on optical coherence tomography (OCT) with microperimetry (MP) and autofluorescence (AF).
patients included in the study underwent an ophthalmic evaluation including best corrected visual acuity (VA), biomicroscopy, color fundus photographs, OCT (Carl Zeiss Meditec), 488 nm AF (HRA II, Heidelberg Eng., Germany), retinal sensitivity and fixation stability with microperimetry system (MP1 Microperimeter, Nidek technologies, Italy).
18 eyes of 17 patients (8 males, 9 females) were included in the study. Eleven eyes presented lamellar MH, 2 eyes stage I MH, 2 eyes stage III MH and 3 eyes stage IV MH. Eyes with lamellar MH presented VA ≥ 0.8 except for 5 eyes presenting lower levels of VA (0.63-0.40) because of the presence of cataract (3 eyes), myopia (1 eye) and pucker with retinal folds (1 eye). VA in stage I MH was 0.63, while in stage III and IV MH was less than 0.2. Location and stability of fixation were respectively: predominantly central and stable in lamellar and stage I MH, poor central and relatively unstable and in stage III and IV MH. MP showed: areas of relative scotoma in lamellar and stage I MH , an absolute scotoma in stage III and IV MH. An irregularly delineated area of increased AF was found in lamellar and stage I MH, while a typical central well demarcated spot of increased AF surrounded by a ring of decreased AF was found in stage III and IV MH.
OCT remains the gold standard technique to diagnose and classify MH. Nevertheless stage III and IV MH can be diagnose on AF because of the presence of peculiar patterns. Correlation was found among, decrease VA, decrease retinal sensitivity, and decrease stability of fixation and centrality of fixation. MP appears a very useful tool to assess retinal sensitivity and to identify the area of retinal fixation thus allowing a correct approach for the peeling of epiretinal membranes and internal limiting membrane.
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