Functional changes measured with SLO in idiopathic macular holes and in macular changes secondary to premacular fibrosis. Function in macular holes.

Abstract

To evaluate fundus perimetry and laser scanning tomography in idiopathic macular holes and premacular fibrosis and to describe specific functional findings of the adjacent retina. Thirty eyes of 30 patients with macular holes and epiretinal membranes (visual acuity 0.05-0.5) aged 64 +/- 13 years were examined using automatic threshold fundus perimetry with simultaneous observation of fixation, as well as a special fixation task with the scanning laser ophthalmoscope (SLO). In addition, area and depth of the holes were measured using scanning laser tomography (Heidelberg retina tomograph). All 21 eyes with full thickness macular holes (0.06-0.75 mm2 area; 0.06-0.53 mm depth) showed an absolute scotoma inside of the hole with location of the fixation area at the left border or top of the hole. In contrast, the patients with impending holes or epiretinal membranes (0.14-0.32 mm2 area, 0.09-0.17 mm depth) could detect bright stimuli during perimetry (10-20 dB and 3-9 dB, respectively). We observed a reduced light increment sensibility (4-13 dB) surrounding the full thickness hole in 15 eyes, either with attached or detached retina. Fundus perimetry with simultaneous documentation of fixation offers the option to detect functional differences between macular holes and changes secondary to epiretinal membrane formation. There is an area of reduced function even in eyes with clinically and tomographically attached retina surrounding the hole which might influence surgical results.