Functional Outcome After Macular Hole Surgery: Comparison of Standard Perimetry with Microperimetry

Figures & data

Table 1 Epidemiological Data

	Group 1 (<250µm) n = 41	Group 2 (250– 400µm) n = 33	Group 3 (>400µm) n = 31	p value
Age (years: mean±SD; min-max)	68.6±7.0	69.5±8.1	68.2±6.8	0.85
	47.8–82.4	47.6–86.1	54.3–80.0
Gender (% females)	65.8	57.6	58.6	0.74
Laterality (% OD)	60.5	30.3	51.7	0.035
Lens status at baseline (% phakic)	84.2	78.8	69.0	0.57
Baseline best-corrected visual acuity (mean ± SD; ETDRS letter scores)	62.4±8.9	56.8±10.8	47.6±14.7	<0.001*
	(20/63)	(20/80)	(20/100)
Macular hole size (mean±SD; min-max)	159.0±65.4	327.0±41.0	541.2±98.6	<0.001^#
	55–248	256–396	410–752
Duration of symptoms (months: mean±SD; min–max)	2.8±2.0	2.9±1.7	3.3±1.9	0.54
	0.1–6.0	0.1–6.0	0.1–6.0

Notes: *Significant difference between group 1 and group 3 (p < 0.001, Kruskal–Wallis H-test). ^#Significant difference between all groups (p < 0.001, Kruskal–Wallis H-test). Significant p-values are marked in bold.

Abbreviations: OD, oculus dexter; SD, standard deviation.

Figure 1 Change in visual acuity (ETDRS scores; 85 ETDRS letters represent a Snellen decimal visual acuity of 1.0) over time after macular hole surgery in relation to macular hole size. Median and interquartile ranges are displayed in parentheses after means and standard deviations. Significant differences (p<0.01) are marked with a *. Differences were found between group 1 (<250µm) and group 3 (>402µm). n: sample size; µm: micrometer.

Table 2 Closure Pattern

	Group 1 (<250µm) n = 38	Group 2 (250–400µm) n = 33	Group 3 (>400µm) n = 29
U pattern N (%)	30 (78.9%)	23 (69.7%)	11 (37.9%)
V pattern N (%)	8 (21.1%)	10 (30.3%)	18 (62.1%)

Table 3 Closure Pattern and Visual Acuity (Measured in ETDRS Letters)

		Group 1 (<250µm) n=38	Group 2 (250–400µm) n=33	Group 3 (>400µm) n=29	p values (Comparison Between the Groups)
U pattern mean±SD	ETDRS t0	62.3±9.1	54.1±11.1	52.3±11.0	0.002*
		62.7(58.9–69.9)	58.9(50.1–60.3)	54.9(45.2–60.3)
	ETDRS t1	72.0±10.0	70.9±7.6	64.9±18.1	0.34
		74.4(68.7–80.2)	73.9(65.1–75.0)	69.9(60.3–73.9)
	ETDRS t2	76.6±8.9	75.0±6.4	75.4±5.7	0.40
		80.2(69.9–81.4)	75.0(69.9–80.2)	75.0(73.9–78.9)
V pattern	ETDRS t0	62.5±8.9	63.1±7.2	44.8±16.2	0.002^#
		62.7(54.9–69.9)	62.7(58.9–65.1)	45.2(35–60.3)
	ETDRS t1	68.0±15.9	70.6±7.9	60.4±13.9	0.09
		74.4(66.3–75.0)	69.9(63.9–80.2)	60.3(50.1–75.0)
	ETDRS t2	70.9±16.5	76.9±6.6	72.0±11.7	0.71
		75.6(62.2–81.4)	77.6(69.9–83.8)	75.0(69.9–80.2)
p values comparison between U and V pattern within the groups		ETDRS t0 p=0.96	ETDRS t0 p=0.018	ETDRS t0 p=0.24
		ETDRS t1 p=0.59	ETDRS t1 p=0.92	ETDRS t1 p=0.26
		ETDRS t2 p=0.40	ETDRS t2 p=0.61	ETDRS t2 p=0.71

Notes: Data are presented as mean±SD, median and interquartile ranges in brackets. ETDRS: Early Treatment Diabetic Retinopathy Study; below the ETDRS letters, the true Snellen fraction is reported in brackets; t0: before surgery, t1: 1 month after surgery, t2: 6 months after surgery. Significant differences are marked in bold. *Significant difference between group 1 and group 2 (p=0.012), as well as between group 1 and group 3 (p=0.015); ^#Significant difference between group 1 and group 3 (p=0.018), as well as between group 2 and group 3 (p=0.009). Comparison between the groups: Kruskal–Wallis H-test. Comparison between U and V pattern within the groups: Mann–Whitney U-test.

Table 4 Sensitivity and Defect

			Group 1 (<250µm)	Group 2 (251–400µm)	Group 3 (>401µm)	p values (Between Groups)*
Sensitivity	MP1	t0	14.7±2.9	14.3±2.6	12.8±3.9	0.58
			15.4(12.8 to 16.8)	15.2(12.7 to 16.4)	12.4(11.2 to 15.8)
		t1	14.8±3.1	13.4±3.6	13.7±3.3	0.21
			15.2(13.9 to 17.0)	14.8(10.9 to 15.9)	13.7(11.4 to 16.5)
		t2	16.4±2.6	15.0±3.7	16.0±2.9	0.40
			17.0(14.8 to 18.2)	16.4(11.5 to 17.5)	17.2(13.5 to 18.3)
	M Top	t0	26.8±2.2	26.6±1.8	26.5±1.4	0.36
			26.9(25.6 to 28.5)	26.7(25.5 to 27.7)	26.3(25.9 to 27.2)
		t1	25.2±2.9	24.4±3.1	25.3±2.8	0.30
			25.7(23.4 to 27.4)	24.6(22.3 to 26.8)	25.8(24.4 to 27.3)
		t2	25.8±2.0	25.1±3.0	26.2±2.3	0.51
			25.9(24.7 to 27.4)	26.2(23.3 to 26.9)	26.6(24.8 to 27.6)
MP1 vs M Top (within group)^#			t0: p<0.001	t0: p<0.001	t0: p<0.001
			t1: p<0.001	t1: p<0.001	t1: p<0.001
			t2: p<0.001	t2: p<0.001	t2: p<0.001
Defect	MP1	t0	5.0±2.7	5.2±2.4	5.8±2.8	0.37
			4.6(2.9 to 6.9)	4.8(3.4 to 6.8)	5.6(3.6 to 7.7)
		t1	4.8±2.7	6.2±3.2	5.7±3.0	0.24
			4.7(3.0 to 6.0)	5.1(4.0 to 8.9)	5.6(3.1 to 8.0)
		t2	3.5±2.4	4.7±3.3	3.8±2.7	0.36
			3.0(1.7 to 5.0)	3.6(2.6 to 7.4)	2.7(1.6 to 6.1)
	M Top	t0	2.8±2.0	2.9±1.7	3.0±1.4	0.54
			2.7(1.2 to 3.8)	2.9(1.7 to 4.0)	3.3(2.4 to 3.7)
		t1	4.3±2.7	5.1±2.9	4.1±2.6	0.20
			3.7(2.3 to 5.3)	4.8(2.8 to 6.7)	3.8(2.3 to 5.1)
		t2	3.6±1.9	4.3±2.8	3.3±2.1	0.51
			3.3(2.0 to 4.8)	3.3(2.6 to 6.2)	2.8(2.0 to 4.9)
MP1 vs M Top (within group)^#			t0: p<0.001	t0: p<0.001	t0: p<0.001
			t1: p=0.10	t1: p=0.004	t1: p=0.003
			t2: p=0.66	t2: p=0.69	t2: p=0.28

Notes: Data are presented as mean±SD, median and interquartile ranges in brackets. MP1: 4° customized program representing the same central visual field points used for the Octopus M Top program; NIDEK-MP1 Microperimeter. M Top: Standard 12-degree perimetry (ie, Octopus M2 program). t0: before surgery, t1: 1 month after surgery, t2: 6 months after surgery; SD: standard deviation. *: The differences refer to differences between groups. ^#: The differences refer to differences between MP1 and M2 within the same group. Comparison between the groups: Kruskal–Wallis H-test. Comparison within one group: Wilcoxon signed-rank test.

Table 5 Fixation Stability in the 2° and 4° Visual Field in Microperimetry

		Group 1 (<250µm) n = 38	Group 2 (250–400µm) n = 33	Group 3 (>400µm) n = 29	p values (Comparison Between the Groups)
T0	Fixation 2°	87.9±16.9	82.7±20.0	74.0±22.6	0.007*
	Fixation 4°	97.1±10.8	95.1±16.6	93.9±10.5	0.008*
T1	Fixation 2°	89.7±13.0	89.9±9.2	80.0±24.8	0.26
	Fixation 4°	98.1±3.6	98.8±2.1	94.1±14.3	0.44
T2	Fixation 2°	92.1±9.5	90.9±8.5	81.3±18.2	0.013*
	Fixation 4°	99.4±1.2	99.0±1.3	96.6±7.0	0.15

Notes: t0: before surgery, t1: 1 month after surgery, t2: 6 months after surgery. Significant differences are marked in bold. *Significant difference between group 1 and group 3.

Data Availability Statement

Data are available at: http://augenklinik-bern.ch/research/Data_Wons_et_al_2021.xlsx.