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. 2021 Apr 7;11(1):7658.
doi: 10.1038/s41598-021-87286-9.

Characteristics of fixation patterns and their relationship with visual function of patients with idiopathic macular holes after vitrectomy

Yuyan Liu  1 , Ying Wang  1 , Yi Dong  1 , Dongqing Liang  2 , Shiyong Xie  1 , Bo Xiao  1 , Yanhua Chu  1 , Quanhong Han  3
Affiliations

Characteristics of fixation patterns and their relationship with visual function of patients with idiopathic macular holes after vitrectomy

Yuyan Liu et al. Sci Rep. .

Abstract

To analyze the relationships between the fixation location and the visual function of idiopathic macular hole (IMH) patients with macular integrity assessment (MAIA) examination preoperatively and 3 months postoperatively. This was a retrospective case analysis. Forty-three eyes of 43 patients diagnosed with IMH were included in this study. The best corrected visual acuity (BCVA) assessments, optical coherence tomography (OCT) and MAIA examinations were performed before surgery and 1 week, 1 month and 3 months after surgery. The relationships between MAIA parameters and visual acuity were assessed by correlation analysis. Grouping by fixation location with the foveola (2°) as the centre, the locations could be divided into five groups, including foveolar, temporal, nasal, inferior and superior fixation. The mean macular sensitivity (MMS) of the macular area was correlated with the BCVA in the IMH patients before and 3 months after surgery (before surgery P = 0.00, after surgery P = 0.00). The MMS could be used as a good indicator for evaluating visual function in IMH patients. There was a significant difference in fixation location before and after the operation (P = 0.01). The preoperative fixation location of IMH patients was mainly in the superior area, while postoperatively moved to the foveola and nasal areas. Paying attention to the changes of fixation locations in IMH patients may provide new clues for further improving postoperative visual function.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Association between the best-corrected visual acuity (BCVA) with mean macular sensitivity (MMS) before and after surgery. The “□” symbols represent preoperative visual acuity and MMS data, and the red “▲” symbols show the postoperative visual acuity and MMS data. The solid lines represent the linear regression curves for the data obtained before and after surgery.
Figure 2
Figure 2
Results of OCT and MAIA examinations in patients with different fixation locations 3 months after surgery. Columns (A) and (B) show the location of the OCT scan and the horizontal B scan, and column (C) shows the MAIA results of the corresponding patients. The first row shows the OCT and MAIA results of patients with foveolar fixation locations, and rows 2, 3 and 4 show the results of patients with temporal, superior, and nasal fixation locations, respectively.
Figure 3
Figure 3
Comparison of preoperatively and postoperatively best corrected visual acuity (BCVA) between different groups according to the preoperative fixation location (F: foveola fixation group; N: nasal fixation group; S: superior fixation group; T: temporal fixation group).
Figure 4
Figure 4
Division diagram of the fixation location based on microperimetry examination results. The inner circle and outer circle represent the 2° and 10° fixation ranges of the macular area respectively. The lines between the two circles are ± 45° with the horizontal line. Fixation locations beyond the foveola were divided into superior, inferior, nasal and temporal fixation locations.
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