Macular pigment and fixation after macular translocation surgery.
BACKGROUND
After full macular translocation (MT) surgery with 360 degrees retinotomy, the fovea is rarely identifiable. Our aim was to verify the position of the fovea, to determine how patients fixate after MT and to examine distribution and optical density of macular pigment (MP).


METHODS
9 patients after MT were investigated. The Utrecht Macular Pigment Reflectometer was used to quantify the MP optical density. A scanning laser ophthalmoscope (SLO) was used to identify the fovea as the centre of MP distribution and determine the retinal locus of fixation.


RESULTS
In all patients, the fovea was identified as the centre of MP distribution. The retinal areas used for fixation were displayed by SLO fixation analysis. Comparing their spatial relationship with the fovea, five patients fixated centrally and four eccentrically up to 7.5 degrees . In those patients, microperimetry showed that the atrophy caused by choroidal neovascularisation (CNV) extraction prevented central fixation.


CONCLUSIONS
The combination of MP distribution and fixation analysis allows fixation behaviour to be quantified, even if the fovea morphologically cannot be localised. Our results suggest that the scotoma caused by spreading chorioretinal atrophy is the main cause for reduced visual acuity after MT, and so the MT rotation angle is crucially important.
Reinhard
Jens
J
Centre for Ophthalmology, University of Tübingen, Tübingen, Germany. jens.reinhard@uni-tuebingen.de
Kanis
Martijn J
MJ
Berendschot
Tos T J M
TT
Schön
Christiane
C
Gelisken
Faik
F
Trauzettel-Klosinski
Susanne
S
Bartz-Schmidt
Karl U
KU
Zrenner
Eberhart
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005403:Fixation, Ocular / Q000502:physiology*; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D014975:Lutein / Q000097:blood; D008266:Macula Lutea / Q000737:chemistry / Q000637:transplantation*; D008875:Middle Aged; D012168:Retinal Pigments / Q000032:analysis*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests
D012168:Retinal Pigments; D014975:Lutein