Abstract
Purpose: :
To evaluate the visual performance pre– and postoperatively of patients with macular holes and macular pucker using microperimetry.
Methods: :
19 patients with macular hole and 18 with macular pucker were studied. The patients’ age was 71.3± 6.5 years in the macular hole group and 65.5 ± 7.6 years in the macular pucker group. Best–corrected visual acuity (LogMAR) and microperimetry (functional macular mapping) were tested before and 12 weeks after operation. Microperimetry was determined with the MP1 (Nidek). Mean dB and stability of fixation performed with the automatic eye tracking during functional macular mapping were evaluated. Hole closure and reduction of macular thickness, respectively, were confirmed with an OCT–scan.
Results: :
Preoperatively, the distance visual acuity was LogMAR 0.68± 0.25 in macular hole patients, and LogMAR 0.58± 0.25 in macular pucker patients. Postoperatively, visual acuity was significantly better in both groups (LogMAR 0.53± 0.26 and LogMAR 0.33 ±0.26, respectively). Functional macular mapping showed a mean dB of 11.3 ±2.5 dB in macular hole patients and 10.7 ±2.8 dB in patients with macular pucker. Postoperatively, the mean dB of both groups was statistically significant better ( 12.8 ±1.9 dB and 12.7 ± 2.5 dB, respectively). Also stability of fixation increased significantly in both groups: The number of patients with stable fixation increased in macular hole patients from 8 to 16 and in macular pucker patients from 5 to 14. 47.3% of macular hole patients and 66.7% of macular pucker patients showed an improvement of visual acuity, but a significantly higher number (68.4% and 77.8%, respectively) had a better outcome in functional macular mapping.
Conclusions: :
The study shows a significant improvement in the central visual field for patients with macular hole and macular pucker postoperatively. Additionally, a higher number of patients improved in microperimetry than with visual acuity testing. These findings highlight the value of the functional macular mapping for these patients and indicate that visual distance acuity alone underestimates the functional benefit of surgery.
Keywords: visual fields • visual acuity • macula/fovea