title: Functional macular mapping in patients with vitreomacular pathologic features before and after surgery.
abstract: OBJECTIVE
  To evaluate the potential benefit of microperimetry and preferential hyperacuity perimeter (PHP) to document visual performance objectively in patients with macular hole and macular pucker undergoing macular surgery.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  In 19 patients with macular hole and 18 with macular pucker, best-corrected visual acuity (BCVA; in logarithm of the minimum angle of resolution units), central retinal sensitivity, and presence and extent of metamorphopsia were documented before and four and 12 weeks after surgery. Macular sensitivity (mean sensitivity decibel [dB], stability of fixation) was determined using MP1 microperimetry (Nidek, Padova, Italy). The PreView-PHP (Carl Zeiss Meditec, Dublin, California, USA) was used to quantify metamorphopsia.
  
  
  RESULTS
  Before surgery, mean BCVA was 0.68 +/- 0.25 (macular holes) and 0.58 +/- 0.25 (macular pucker). Microperimetry demonstrated a mean retinal sensitivity of 11.3 +/- 2.5 dB (macular holes) and 10.7 +/- 2.8 dB (macular pucker). Twelve weeks after surgery, mean BCVA improved to 0.53 +/- 0.26 (macular holes) and 0.33 +/- 0.26 (macular pucker; P = .042 and P = .004). Accordingly, retinal sensitivity increased significantly with 12.8 +/- 1.9 dB (macular holes) and 12.7 +/- 2.5 dB (macular pucker; P = .04 and P = .02) as well as stability of fixation. At 12 weeks, 47.3% of macular hole eyes and 66.7% of macular pucker eyes improved in BCVA, but a significantly higher number (68.4% [macular holes] and 77.8% [macular pucker]) demonstrated improvement in microperimetry results. PHP results showed no significant change of scotomas, patient reliability, or presence of metamorphopsia at any interval.
  
  
  CONCLUSIONS
  A higher number of patients improved in microperimetry than in visual acuity testing. Therefore, microperimetry highlights the value of functional macular mapping for these patients and indicates that BCVA may underestimate functional benefit of surgery.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Sibylla
authors.initials: S
authors.lastname: Richter-Mueksch
authors.forename: Pia V
authors.initials: PV
authors.lastname: Vécsei-Marlovits
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Sacu
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Kiss
authors.forename: Birgit
authors.initials: B
authors.lastname: Weingessel
authors.forename: Ursula
authors.initials: U
authors.lastname: Schmidt-Erfurth
mesh_terms: D000368:Aged; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000503:physiopathology* / Q000601:surgery; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D014821:Vitrectomy