Visual Function after Limited Macular Translocation for Myopic Neovascular Maculopathy

Abstract

Abstract: : Purpose: In this study, we investigated the effect of limited macular translocation on binocular visual function by assessing various visual functions. Methods: Thirteen eyes of 13 patients (ages 50 to 74 years) who had been observed for 6 months or longer after limited macular translocation for myopic neovascular maculopathy were studied. Pre- and post-operative subjective diplopia, central scotoma, and metamorphosia were inquired. Pre- and post-operative visual acuity; distance of macular translocation; postoperative ocular deviation, cyclodeviation and suppression by Bagolini striated glass test, stereopsis by FLY using Titmus stereo test, reading ability by MNREAD-J^TM , and metamorphosia scores by M-CHARTS^TM were evaluated . Results: Subjective diplopia was reported by 0 and 4 patients before and after surgery, respectively; central scotoma in 13 and 5 patients, and metamorphosia in 5 and 10 patients. Preoperative visual acuity was 0.09 or below in 4 eyes, and 0.1 to 0.3 in 9 eyes; whereas postoperative visual acuity was 0.09 or below in 2 eyes, 0.1 to 0.3 in 5 eyes, and 0.4 or above in 6 eyes. The mean macular translocation distance was 0.35 (0.09 to 0.7) disc diameter. Ocular deviation occurred in 5 patients, 4 of whom achieved stereopsis. Cyclodeviation was found in only 1 eye performed the maximum translocation. Suppression was observed for distance in only 3 patients with significant visual acuity difference (between left and right eyes), and was not observed for near in all patients. There was no difference in binocular and monocular reading ability in 10 patients. Postoperative metamorphosia averaged 0.6 degree longitudinally and 0.9 degree horizontally. No correlation between the metamorphosia score and the distance of translocation was observed. Conclusions: Limited macular translocation producing little scleral shortening is useful for treating myopic neovascular maculopathy from the viewpoint of preserving binocular visual function and binocular reading ability.

Keywords: choroid: neovascularization • myopia • binocular vision/stereopsis