Preoperative measurements of macular hole with scanning laser ophthalmoscopy. Correlation with functional outcome

Abstract

ABSTRACT.Purpose: To measure the dimensions of macular holes before surgery and compare them with the functional outcome. Methods: A prospective study of ten consecutive patients scheduled for macular hole surgery. Macular holes were imaged with scanning laser ophthalmoscopy with different laser wavelengths. Computerized image analyses were used to measure the size of the hole and the surrounding rim. Results: Eyes were referred to three different groups preoperatively according to visual function. Measurements of the longest diameter and the area of the macular hole were found to correlate well with visual function tested before and after surgery. All holes closed after one operation. Eighty per cent of eyes improved two or more lines on the distance visual chart and all patients but one could read a newspaper six months after surgery. Conclusion: Preoperative size of macular hole can be used as a predictor of the functional outcome of macular hole surgery.

Visual performance 3 years after successful macular hole surgery

“…Analysis of macular microperimetry showed in previous studies15 24 – 28 that eyes with open macular holes have an absolute scotoma that corresponds to the neurosensory defect as well as a surrounding relative scotoma that corresponds to the surrounding neurosensory retinal detachment. These studies found that the size of the absolute scotomata correspond to the best-corrected visual acuity.…”

Predicting Visual Outcome following Surgery for Idiopathic Macular Holes

“…Traditionally, MH size had been estimated based on biomicroscopic observation or photographic evaluation. As imaging technology developed and became applicable to fundus assessment, more attempts were made to measure MH size precisely [54,55]. In 2002, Ip et al [56] first used optical coherence tomography (OCT), the most common method used today, to quantify MH size.…”

Microperimetry and Multimodal Retinal Imaging

“…This fi nding suggests that pathologic lipofuscin accumulation in the RPE surrounding areas of GA has reduced retinal sensitivity as functional correlate. In postmortem specimens obtained from patients with GA due to AMD, a linear relationship between the loss of RPE and choriocapillaris atrophy has been observed [ 66 ]. But reduced retinal sensitivity may directly depend on alterations in photoreceptor (PR) function along the border of GA as recently hypothesized by Bearelly et al [ 49 ].…”

“…Schmitz-Valckenberg et al, using SLO microperimetry, found reduced retinal sensitivity in the areas of increased FAF bordering GA compared to areas with normal FAF [ 65 ]. The fi rst one is that RPE atrophy causes secondary choriocapillaris loss and PR degeneration [ 66 ]. Preliminary data also suggest that NIR-FAF better correlates to retinal sensitivity changes compared to SW-FAF [ 14 , 16 ].…”