Association of preoperative photoreceptor displacement and improved central scotoma after idiopathic macular hole surgery.
OBJECTIVE
To investigate the relationship between preoperative photoreceptor displacement and postoperative scotoma after unilateral idiopathic macular hole surgery.


METHODS
Prospective nonrandomized comparative self-controlled trial.


METHODS
Twenty patients who underwent successful surgery for unilateral idiopathic macular hole participated in the study.


METHODS
Kinetic perimetry using red and green filter glasses, black binocular fixation targets, and red and green selective monocular stimuli was performed preoperatively. Scanning laser ophthalmoscope (SLO) microperimetry was performed preoperatively and postoperatively.


RESULTS
Sixteen patients had photoreceptor displacement preoperatively. In preoperative SLO microperimetry, all eyes with a macular hole had a scotoma; postoperatively, 12 of 16 had no scotoma. All four eyes with no preoperative photoreceptor displacement were noted to have a postoperative scotoma. The prevalence of postoperative scotoma in patients with preoperative photoreceptor displacement (4 of 16; 25%) was significantly lower than that in patients without preoperative photoreceptor displacement (4 of 4; 100%) (P = 0.03).


CONCLUSIONS
The presence or absence of photoreceptor displacement preoperatively should affect postsurgical visual function. Photoreceptor damage may occur in eyes without photoreceptor displacement preoperatively, resulting in scotoma postoperatively.
Hikichi
Taiichi
T
Department of Ophthalmology, Asahikawa Medical College, Asahikawa, Japan. hikichi@sahikawa-med.ac.jp
Kitaya
Norihiko
N
Takahashi
Jun-Ichi
J
Ishiko
Satoshi
S
Mori
Fumihiko
F
Yoshida
Akitoshi
A
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000502:physiology*; D011300:Preoperative Care; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery*; D012607:Scotoma / Q000503:physiopathology*; D015348:Vision, Binocular; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology