Abstract
Purpose: :
To investigate changes in colour vision after surgical repair of full thickness macula hole and to compare three types of colour vision assessment.
Methods: :
Patients underwent vitrectomy surgery with Indocyanine Green Inner Limiting Membrane peel and combined lens extraction with intraocular lens implantation. Colour vision was assessed using the Ishihara Pseudoisochromatic Plates (IPP), the Farnsworth Munsell 100 hue (FM) test and the Cambridge Colour Contrast Trivector (CCCT) test done in random order. Refractive error, LogMAR acuity using the EDTRS chart and contrast sensitivity using the Pelli–Robson chart was also assessed. Patients underwent ocular examination and optical coherence tomography (OCT) of the macular. Testing was done prior to surgery and 6 months postoperatively.
Results: :
Six eyes (4 left) of six patients (1 male) were tested. The median age of patients was 70 years (SD 4.6). OCT scanning showed macula hole closure in all patients by 6 months. They had a median refractive error of 0.25 (SD 2.3) at baseline and –0.75 (SD 1.67) at 6 months. There was an increase in the number of EDTRS letters from 15.0 (SD 8.1) at baseline to 33.5 (SD 17.2) at 6 months. The median number of triplets correctly identified on the Pelli–Robson contrast sensitivity test was 10 (SD 3.9) at baseline and 11 (SD 1.5) at 6 months. At baseline patients correctly identified 10.5 IPP plates (SD 5.9) and this increased to a median of 16.0 plates at 6 months (IQ range 13.5 to 16.3 p=0.06). The median of the square root of the total error score was 12.9 (SD 2.4) at baseline and 12.9(SD 1.8, p=0.753) at 6 months. The median square root partial error scores for the blue–yellow (B–Y) and red–green (R–G) axis were 10.1 (SD 2.0) and 8.8 (SD 1.6) at baseline and 10.6 (SD 1.1 p= 0.753) and 8.5 (SD 3.9, p=0.917) at 6 months. At baseline, CCT demonstrated median protan, deutan and tritan thresholds of 226.5 (IQ range 163.0 to 493.3), 271.0 (IQ range 171.0 to 507.5) and 463.0 (IQ range 346.8 to 758.8). At 6 months the protan and deutan and tritan thresholds were 139.5 (IQ range 123.3 to 243.5, p=0.046), 164.0 (IQ range 119.5 to 275.3, p=0.046) and 256.0 (IQ range 201 to 716, p=0.225) respectively.
Conclusions: :
These data show significant improvements in colour vision on the red–green axis after successful macular hole surgery demonstrated with the Cambridge Colour Contrast test. Similar improvements were seen with the Ishihara Pseudoisochromatic plates and this came close to statistical significance. There were no significant changes between FM100 results at baseline and at 6 months
Keywords: macular holes • color vision