title: Effect of preoperative retinal sensitivity and fixation on long-term prognosis for idiopathic macular holes.
abstract: BACKGROUND
  To study the roles of preoperative retinal sensitivity and fixation exams in predicting the long-term prognosis of idiopathic macular hole (IMH) patients after successful vitrectomy.
  
  
  METHODS
  A total of 39 IMH patients (39 eyes) were included in this prospective cohort case series study. Twenty-three gauge pars plana vitrectomy was performed on each patient. Results of best-corrected visual acuity (BCVA), macular hole diameter, MP - 1 microperimetry (MP - 1) tests, and continuity of the photoreceptor inner and outer segment (IS/OS) junction were recorded for analysis.
  
  
  RESULTS
  Postoperative BCVA at 12 months was significantly correlated with macular hole diameters (p < 0.05), preoperative BCVA (p = 0.020), mean retinal sensitivity (p < 0.001), and fixation location percentage (p < 0.001). However, merely preoperative mean retinal sensitivity (r = 0.5448, p < 0.001) and fixation location percentage (r = 0.5624, p < 0.001) were suggested to be quantitatively predictive for the visual prognosis by multiple stepwise linear regression analysis. Moreover, patients that had smaller hole sizes (p < 0.01), better mean retinal sensitivity (p = 0.003), higher fixation quality scores, and higher fixation location percentage (p = 0.008) before surgery were prone to get continuous IS/OS junction 12 months after surgery.
  
  
  CONCLUSIONS
  MP-1 exams evaluate the dysfunctional hole margin and thus provide more comprehensive information of the preoperative visual function of IMH patients. Both mean retinal sensitivity and fixation behaviors are ideal measurements in predicting the prognosis after successful macular hole surgery.
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, People's Republic of China. zhongcui.sun@yahoo.com.cn
authors.forename: Zhongcui
authors.initials: Z
authors.lastname: Sun
authors.forename: Dekang
authors.initials: D
authors.lastname: Gan
authors.forename: Chunhui
authors.initials: C
authors.lastname: Jiang
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Alicia
authors.initials: A
authors.lastname: Sprecher
authors.forename: Alice C
authors.initials: AC
authors.lastname: Jiang
authors.forename: Gezhi
authors.initials: G
authors.lastname: Xu
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012167:Retinal Perforations / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D014821:Vitrectomy