Standard Perimetry, Microperimetry Perform Similarly After Macular Hole Surgery

A lamellar macular hole results from the thin lamella layer of the macula separating and lifting up from the layer beneath it.
The tests are equally suitable to describe central visual function in patients with macular pathologies.

Standard visual field testing appears to perform similarly to microperimetry testing in describing perioperative central visual function in macular pathologies, according to a study published in Clinical Ophthalmology.

Researchers conducted a retrospective, nonrandomized case series to compare the predictive value of macular perimetry and microperimetry for visual outcomes after vitrectomy with internal limiting membrane (ILM) peeling in full-thickness macular holes (MH). They assessed perioperative best-corrected visual acuity (BCVA) in microperimetry (4° field) and standard macular perimetry (12° field) and evaluated associations between predictive value of the preoperative findings and postoperative visual function (PVF).

Between January 2011 and December 2016, a total of 100 eyes of 100 patients underwent vitrectomy with ILM peeling and met the study inclusion criteria. The patients had a mean MH size of 325±170 μm (range 55-752 µm). At 1 month postoperatively, MH closure was achieved in all eyes, and after 6 months, the BCVA improved from 56.3±12.8 to 74.8±9.2 Early Treatment of Diabetic Retinopathy Study letters. No postoperative surgical complications were reported during the follow-up period.

The researchers found a positive correlation between the BCVA and macular sensitivity 6 months postoperatively in 4° microperimetry (r=0.48; P <.010) and 12° perimetry (r=0.45; P <.014) as well as with mean defect (r=0.48; P <.01 and r=0.44; P <.017, respectively). They did not observe any correlations between preoperative visual function indices and PVF. 

“Microperimetry and standard perimetry are equally suitable for describing perioperative retinal function in idiopathic MH,” according to the researchers. “While the indices of both methods correlate comparably well with BCVA, they cannot predict PVF.”

The primary limitations of the study were the retrospective design and relatively small sample size.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  


Wons J, Pfister IB, Anastasi S, Steinhauer S, Niderprim SA, Garweg JG. Functional outcome after macular hole surgery: comparison of standard perimetry with microperimetry. Clin Ophthalmol. 2022;16:2235-2243. Published online July 11, 2022. doi:10.2147/OPTH.S367431