Fixation stability, fixation location, and visual acuity after successful macular hole surgery.

PURPOSE This study examined whether changes in fixation stability and fixation location are good predictors of visual acuity after successful macular hole surgery. METHODS Ten patients with macular hole were tested before surgery and at 1 and 3 months after surgery. Visual acuity was measured with the ETDRS; fixation stability and fixation location were assessed with the MP-1 Microperimeter (Nidek Technologies Srl., Vigonza, PD, Italy). The quantitative measure of fixation stability was calculated with a bivariate contour ellipse area (BCEA). Fixation location shift was evaluated using the differential map analysis feature of the MP-1 Microperimeter. RESULTS There was a significant improvement in visual acuity after macular hole closure. Fixation location shifted an average of 0.55 deg and 0.87 deg at 1 month and 3 months after surgery, respectively. The fixation shift was not a good predictor of visual outcome. Fixation stability improved from an average of 0.35 deg(2) before surgery to 0.29 deg(2) at 3 months after surgery. The change in fixation stability (DeltaBCEA = BCEA before - BCEA after surgery) correlated highly with visual outcome. The regression model showed that DeltaBCEA accounted for a significant proportion of the variance in visual acuity both 1 and 3 months after surgery. CONCLUSIONS Some changes in ocular motor function explain the visual outcome after the anatomic success of macular hole surgery. Fixation location shift has no influence on visual acuity post-operatively; however, change in fixation stability is a strong predictor of visual outcome after successful closure of the macular hole.

[1]  Y Grall,et al.  Functional assessment of macular hole surgery by scanning laser ophthalmoscopy. , 1998, Ophthalmology.

[2]  G. Rubin,et al.  Visual function and quality of life following vitrectomy and epiretinal membrane peel surgery , 2006, British Journal of Ophthalmology.

[3]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[4]  MICHAEL D. CROSSLAND,et al.  The Use of an Infrared Eyetracker to Measure Fixation Stability , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[5]  J. Faubert,et al.  Visual function assessment and metamorphopsia after macular hole surgery *,† , 2005, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[6]  A. Kampik,et al.  Macular changes after peeling of the internal limiting membrane in macular hole surgery. , 2001, American journal of ophthalmology.

[7]  M. Steinbach,et al.  FIXATION CHARACTERISTICS OF PATIENTS WITH MACULAR DEGENERATION RECORDED WITH THE MP-1 MICROPERIMETER , 2008, Retina.

[8]  G. Miura,et al.  EARLY POSTOPERATIVE MACULAR MORPHOLOGY AND FUNCTIONAL OUTCOMES AFTER SUCCESSFUL MACULAR HOLE SURGERY , 2007, Retina.

[9]  W. Feuer,et al.  Long-term anatomic and visual acuity outcomes after initial anatomic success with macular hole surgery. , 2003, American journal of ophthalmology.

[10]  M. Steinbach,et al.  Fixation stability using radial gratings in patients with age-related macular degeneration. , 2006, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[11]  M. la Cour,et al.  Macular holes: classification, epidemiology, natural history and treatment. , 2002, Acta ophthalmologica Scandinavica.

[12]  G. Rubin,et al.  Visual function and subjective perception of visual ability after macular hole surgery. , 2004, American journal of ophthalmology.

[13]  R. Uemoto,et al.  Macular configuration determined by optical coherence tomography after idiopathic macular hole surgery with or without internal limiting membrane peeling , 2002, The British journal of ophthalmology.

[14]  Wolfgang Drexler,et al.  Ultrahigh-resolution optical coherence tomography of surgically closed macular holes. , 2006, Archives of ophthalmology.

[15]  P. Massin,et al.  Relationship between macular hole size and the potential benefit of internal limiting membrane peeling , 2006, British Journal of Ophthalmology.

[16]  R. Murphy,et al.  Surgical management of macular holes: a report by the American Academy of Ophthalmology. , 2001, Ophthalmology.

[17]  Akitoshi Yoshida,et al.  Irregularity of photoreceptor layer after successful macular hole surgery prevents visual acuity improvement. , 2004, American journal of ophthalmology.

[18]  Christos Haritoglou,et al.  Long-term follow-up after macular hole surgery with internal limiting membrane peeling. , 2002, American journal of ophthalmology.

[19]  U. Schmidt-Erfurth,et al.  Functional macular mapping in patients with vitreomacular pathologic features before and after surgery. , 2007, American journal of ophthalmology.

[20]  Y. Tano,et al.  FIXATION PATTERNS OF IDIOPATHIC MACULAR HOLES AFTER VITREOUS SURGERY , 2000, Retina.

[21]  B. Tabachnick,et al.  Using Multivariate Statistics , 1983 .

[22]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[23]  S. Priglinger,et al.  FIVE-YEAR FOLLOW-UP OF MACULAR HOLE SURGERY WITH PEELING OF THE INTERNAL LIMITING MEMBRANE: Update of a Prospective Study , 2006, Retina.

[24]  Po Box,et al.  Photoreceptor layer features in eyes with closed macular holes: Optical coherence tomography findings and correlation with visual outcomes , 2005 .

[25]  R. Wendel,et al.  Vitreous surgery for idiopathic macular holes. Results of a pilot study. , 1991, Archives of ophthalmology.

[26]  M. Crossland,et al.  Evaluation of a new quantitative technique to assess the number and extent of preferred retinal loci in macular disease , 2004, Vision Research.

[27]  W. Wittich,et al.  Differences between recognition and resolution acuity in patients undergoing macular hole surgery. , 2006, Investigative ophthalmology & visual science.

[28]  George T Timberlake,et al.  Retinal Location of the Preferred Retinal Locus Relative to the Fovea in Scanning Laser Ophthalmoscope Images , 2005, Optometry and vision science : official publication of the American Academy of Optometry.

[29]  S. Priglinger,et al.  Visual quality of life after macular hole surgery: outcome and predictive factors , 2006, British Journal of Ophthalmology.