Correlation Between Microperimetry Findings And Visual Outcome After 25-gauge Vitrectomy In Idiopathic Macular Hole

Purpose:To evaluate if preoperative macular function, evaluated by microperimetry, is correlated with postoperative best-corrected visual acuity (BCVA) after 25-gauge pars plana vitrectomy in idiopathic macular hole. Methods:This prospective study included 36 eyes with stage III-IV idiopathic macular undergoing pars plana vitrectomy with trypan blue-assisted internal limiting membrane peeling and C3F8 tamponade with subsequent face-down posturing; only eyes with successful macular hole closure were enrolled. BCVA (logarithm of the minimum angle of resolution- logMAR), and microperimetry were evaluated at baseline, 3 and 6 months after surgery. Macular sensitivity, stability and location of fixation were evaluated by using MP-1 microperimetry (Nidek). A multivariate regression analysis was performed to evaluate the correlation of microperimetry data with 6-month outcomes of BCVA. Results:At baseline mean macular sensitivity was 11.5±4.8 dB, the location of fixation was predominantly central in 56%, poor central in 16%, and predominantly eccentric in 28%; the fixation was stable in 70%, relatively unstable in 19%, and unstable in 11%. Mean BCVA improved from 0.71±0.3 before surgery to 0.39±0.2 logMAR at 6 months (ANOVA p<0.001). Multivariate regression analysis showed that 6-month BCVA was directly correlated with preoperative mean retinal sensitivity (P=0.001) and predominantly central fixation localization (P=0.019) and inversely correlated with predominantly eccentric fixation localization (P=0.025). Conclusions:These results suggest that a predominantly central localization of fixation and high macular sensitivity may be important predictors of good postoperative visual outcome after anatomically successful macular hole surgery.