Aniseikonia and Foveal Microstructure in Patients with Idiopathic Macular Hole

Abstract

To quantify the severity of aniseikonia in patients undergoing vitrectomy for idiopathic macular hole (MH) and to examine any relationship between aniseikonia and the foveal microstructure. Prospective, consecutive, interventional case series. We included 56 eyes of 56 patients who underwent vitrectomy to treat idiopathic MH. We examined visual acuity, aniseikonia using the New Aniseikonia Test, and foveal structure using optical coherence tomography (OCT) before and 3, 6, and 12 months after surgery. Based on OCT images, minimum and base diameters of MH, height of MH, and defect lengths of the external limiting membrane (ELM), ellipsoid zone, and interdigitation zone were assessed. Degree of aniseikonia before and after surgery. The mean aniseikonia was-3.2±4.6%, ranging from-15.5% to+5.0%. Of the patients, 55% had micropsia, 7% had macropsia, and 38% had no aniseikonia. The mean absolute value of aniseikonia improved significantly from 3.8±4.1% before surgery to 1.0±1.5% at 12 months after surgery (P < 0.0001). The preoperative mean absolute value of aniseikonia showed a significant correlation with minimum diameters of MH (P < 0.01), base diameters of MH (P < 0.01), and the defect length of ELM (P < 0.05). In multivariate analysis, preoperative aniseikonia showed a significant correlation with the defect length of ELM (P < 0.05). In contrast, postoperative aniseikonia was not associated with any of the parameters. Approximately half of MH patients had micropsia. Vitrectomy for MH improved aniseikonia. Preoperative aniseikonia was associated with MH size and the defect length of ELM.