Abstract
Purpose: :
To analyze the role of both morphological and functional retinal assessment to better understand macular pucker surgery outcomes.
Methods: :
This prospective study included 23 eyes of 23 consecutive patients affected by macular pucker who underwent standard macular surgery. Morphological examinations and functional assessments were evaluated at baseline and at month 1, 3 and 6 after surgery. Morphological examination was performed by Spectral OCT (OTI, Toronto, Canada) evaluating type and thickness of macular edema. Functional assessment included visual acuity, retinal sensibility and fixation pattern using the microperimeter (MP1, Nidek Technologies, Padova, Italy).
Results: :
Presurgical morphological quantitative evaluation showed mean retinal thickness of 493.50±85.87 µm; after surgery, at day 30 we found 355.50±73.28 µm, at day 90 323.70±77.40 µm, at day 180 313.17±80.75 µm. Presurgical functional evaluation showed LogMAR mean visual acuity of 0.56±0.19 and retinal sensitivity of 11.14±3.30 dB; after surgery, at day 30 we found 0.40±0.19 and 11.73±3.33 dB, at day 90 0.41±0.17 and 12.06±4.14 dB, at day 180 0.32±0.17 and 12.18±2.44 dB. Overall macular thickness reduction and visual acuity increase resulted statistically significant (p<0.05) at each control during the follow up. Mean retinal sensibility increase resulted significant (p<0.05) between baseline and day 180. Fixation pattern improved significantly (p<0.05), showing a stable fixation in 12 of 23 patients (57%) at baseline, in 17 of 23 patients (74%) at day 30 and in 20 of 23 patients (87%) at day 180, suggesting a significative recovery on visual performances.
Conclusions: :
Our study, as already known in literature, shows macular thickness reduction significantly related to visual acuity increase. Moreover, functional evaluation we performed underlined the role of microperimetry (retinal sensibility and fixation pattern) to complete visual acuity examination for a better definition of the efficacy of surgical treatment. Overall, our study showed that morphological retinal analysis associated to functional assessment could best evaluate clinical effectiveness of the therapy applied.
Keywords: macula/fovea • vitreoretinal surgery • imaging/image analysis: clinical