High myopic patients with and without foveoschisis: morphological and functional characteristics.

PURPOSE: Myopic foveoschisis (MF) is characterized by the splitting of the retinal layers in the fovea of patients with high myopia (HM). MF may progress into foveal detachment or macular hole formation with consequent loss of central vision. The aim of this study is to investigate morphological and functional changes of the macular region in myopic subjects with and without foveoschisis. DESIGN: Observational, cross-sectional, comparative study. METHODS: Forty-eight patients with HM and 24 healthy controls were evaluated by spectral domain-optical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and microperimetry (MP-1) tests to assess macular thickness, functionality and sensitivity values, respectively. The results of the diagnostic examinations were compared between three groups: HM patients with MF (N = 24), HM patients without MF (N = 24) and control group (CG) (N = 24). All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). One-way analysis of variance (ANOVA) followed by Tukey's post hoc test was used to analyze differences between groups unless specified; p values < 0.05 were considered as statistically significant. Gender distribution was compared by the Chi square test. RESULTS: The statistical analysis with one-way ANOVA followed by Tukey's post hoc test showed a significant increase in macular thickness in HM patients with MF when compared to both HM patients without MF and CG. Morphological changes were associated with functional impairment as demonstrated by the significant decrease in amplitude of the P1 wave and MP-1 sensitivity (p < 0.05), according to the anatomical landmarks. CONCLUSIONS: This study showed that the morphological changes observed in the central retina of HM patients with MF are associated with functional alterations. High-tech diagnostic tests such as SD-OCT, mfERG and MP-1 could be useful for management in complications of MF.

Microperimetría MP1 en agujero macular idiopático / Microperimetry MP1 for idiopathic macular hole

OBJETIVO: Describir patrones de sensibilidad retiniana y de fijación en ojos afectados de agujero macular idiopático y ojos contralaterales con estadios 0 determinados por tomografía de coherencia óptica a 35 pacientes con agujero macular idiopático diagnosticados en consulta de retina del Instituto Cubano de Oftalmología Ramón Pando Ferrer en los años 2006 y 2007. MÉTODOS: Se le realizó a cada paciente en ambos ojos microperimetría MP1 y tomografía de coherencia óptica con el empleo del Stratus 3000 en el momento del diagnóstico. RESULTADOS: La tomografía de coherencia óptica demostró en el ojo contralateral sano la presencia de estadio 0 en 7 pacientes, que presentaron según microperimetría una ligera disminución de la sensibilidad retiniana con una media de 12,5 dB en el centro de la fóvea. Se observó la aparición de escotomas absolutos dentro de los 2 grados centrales a partir del estadio 2,y se identifica la aparición de escotomas relativos desde el estadio 0. Los estadios 0, 1a y 1b presentaron una fijación estable predominantemente central con una dispersión de un 5 por ciento fuera de los 2 grados centrales. Se observó correlación directa estadísticamente significativa entre la disminución de la sensibilidad retiniana y la disminución del grosor retiniano a nivel foveolar en el momento del diagnóstico. CONCLUSIONES: La microperimetría constituye una herramienta importante para detectar alteraciones funcionales en estadios precoces en ojos contralaterales permitiendo a su vez una valoración integral del binomio función morfología en asociación con la tomografía de coherencia óptica

OBJETIVE: To describe patterns of retinal sensitivity and fixation in eyes with idiopathic macular hole and in contralateral eyes at stage 0 determined by the optical coherence tomography in 35 patients suffering idiopathic macular hole, who had been diagnosed in the Retinal Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology in 2006 and 2007. METHODS: Each patient underwent MP1 microperimetry and optical coherence tomography in his/her eyes, using Stratus 3000 at the time of diagnosis. RESULTS: The optic coherence tomography showed the stage 0 in the healthy contralateral eye of 7 patients, with a slight decrease of retinal sensitivity in the center of the fovea (mean= 12.5 db) according to the microperimetry. The occurrence of absolute scotomas within the 2 central degrees was observed from the stage II on, whereas the relative scotomas were identified from the stage 0. The stages 0, 1a and 1b had a predominantly central stable fixation with 5 percent dispersion off the 2 central degrees. A direct statistically significant correlation was found between the reduced retinal sensitivity and the decreased foveal retinal thickness at the time of diagnosis. CONCLUSIONS: Microperimetry was an important tool to detect functional alterations at initial stages in contralateral eyes, thus allowing a comprehensive morphological and functional assessment of these patients by means of the optical coherence tomography

Microperimetría MP1 en agujero macular idiopático / Microperimetry MP1 for idiopathic macular hole

OBJETIVO: Describir patrones de sensibilidad retiniana y de fijación en ojos afectados de agujero macular idiopático y ojos contralaterales con estadios 0 determinados por tomografía de coherencia óptica a 35 pacientes con agujero macular idiopático diagnosticados en consulta de retina del Instituto Cubano de Oftalmología Ramón Pando Ferrer en los años 2006 y 2007. MÉTODOS: Se le realizó a cada paciente en ambos ojos microperimetría MP1 y tomografía de coherencia óptica con el empleo del Stratus 3000 en el momento del diagnóstico. RESULTADOS: La tomografía de coherencia óptica demostró en el ojo contralateral sano la presencia de estadio 0 en 7 pacientes, que presentaron según microperimetría una ligera disminución de la sensibilidad retiniana con una media de 12,5 dB en el centro de la fóvea. Se observó la aparición de escotomas absolutos dentro de los 2 grados centrales a partir del estadio 2,y se identifica la aparición de escotomas relativos desde el estadio 0. Los estadios 0, 1a y 1b presentaron una fijación estable predominantemente central con una dispersión de un 5 por ciento fuera de los 2 grados centrales. Se observó correlación directa estadísticamente significativa entre la disminución de la sensibilidad retiniana y la disminución del grosor retiniano a nivel foveolar en el momento del diagnóstico. CONCLUSIONES: La microperimetría constituye una herramienta importante para detectar alteraciones funcionales en estadios precoces en ojos contralaterales permitiendo a su vez una valoración integral del binomio función morfología en asociación con la tomografía de coherencia óptica(AU)

OBJETIVE: To describe patterns of retinal sensitivity and fixation in eyes with idiopathic macular hole and in contralateral eyes at stage 0 determined by the optical coherence tomography in 35 patients suffering idiopathic macular hole, who had been diagnosed in the Retinal Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology in 2006 and 2007. METHODS: Each patient underwent MP1 microperimetry and optical coherence tomography in his/her eyes, using Stratus 3000 at the time of diagnosis. RESULTS: The optic coherence tomography showed the stage 0 in the healthy contralateral eye of 7 patients, with a slight decrease of retinal sensitivity in the center of the fovea (mean= 12.5 db) according to the microperimetry. The occurrence of absolute scotomas within the 2 central degrees was observed from the stage II on, whereas the relative scotomas were identified from the stage 0. The stages 0, 1a and 1b had a predominantly central stable fixation with 5 percent dispersion off the 2 central degrees. A direct statistically significant correlation was found between the reduced retinal sensitivity and the decreased foveal retinal thickness at the time of diagnosis. CONCLUSIONS: Microperimetry was an important tool to detect functional alterations at initial stages in contralateral eyes, thus allowing a comprehensive morphological and functional assessment of these patients by means of the optical coherence tomography(AU)