Objective To observe the changes of anatomic structure and visual function after surgery in highly myopia patients with macular hole and retinal detachment (MHRD). Methods Twentyfive patients (25 eyes) with MHRD who underwent vitreous and internal membrane peeling surgery combined with silicone oil tamponade, were enrolled in this study. All the patients had undergone the examinations of logarithm of minimal angle of resolution (logMAR) visual acuity, optical coherence tomography (OCT), MP-1 microperimetry and multifocal electroretinogram (mf-ERG) before and three months after surgery. The visual acuity, structure of macular hole and macula, fixation point, mean sensitivity (MS) within 10° of macular area and four quadrants including supertemporal, supernasal, intranasal and infratemporal, average response densities of N1 and P1 waves at all 6 rings before and after surgery were observed. Results Three months after surgery, the logMAR visual acuity improved (t=8.265， P＜0.05). Twentyfour eyes (96%) were anatomically reattached, one eye (4%) was not anatomically reattached completely. The results of MP-1 microperimetry showed that foveal fixation was found in two eyes (8%), weak foveal fixation was found in four eyes (16%), paracentral fixation was found in 19 eyes (76%). There were four eyes (16%) with stable fixation, nine eyes (36%) with relatively unstable fixation and 12 eyes (48%) with unstable fixation. The MS value within 10° of macular area was 9.031±4.245 dB. The MS value difference among four quadrants was statistically significant (F=7.40，P=0.015). The mf-ERG results showed that the average response densities of N1 and P1 waves at all 6 rings were increased (P＜0.05). Conclusion The macular hole heals, retina remains reattached, visual acuity, and fixation are improved in the most of MHRD eyes after surgery.
Objective To observe the macular structure changes and its relationship with visual function in patients with idiopathic macular hole (IMH). Methods Forty-seven patients (47 eyes) with IMH who underwent pars plana vitrectomy were enrolled in this study. All patients were examined including bestcorrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscopy, B-scan ultrasonography, optical coherence tomography (OCT) and MP-1. All the patients underwent a standard three-port pars plana vitrectomy. The BCVA, mean light sensitivity (MS) in macular area, macular hole diameter, the photoreceptor inner and outer segment (IS/OS) junction defect, external limiting membrane (ELM) defect were observed on the 1st, 3rd and 6th months after surgery, and then the relationship of IS/OS junction defect, ELM defect, sensitive and BCVA were analyzed. Results The 1st, 3rd and 6th months after surgery, the logarithm of minimal angle of resolution (logMAR) BCVA (t=16.4, 35.7, 20.7; P＜0.05) and MS （t=－13.8, －17.9, －2.5; P＜0.05） were improved significantly; the macular hole diameter （t=7.7, 7.7, 7.7;P＜0.05）, IS/OS junction defect （t=24.1, 19.3, 27.4; P＜0.05） and ELM （t=20.5, 6.7, 15. 8; P＜0.05） defect were decreased significantly. Preoperative IS/OS junction defect and ELM defect were both related to sensitive （r=-0.55, -0.53; P＜0.05）, but uncorrelated with BCVA （r=0.13, 0.13; P＞0.05）. IS/OS junction defect and ELM defect 1st, 3rd and 6th months after surgery were both related to MS and BCVA （P＜0.05）. Conclusions The logMAR BCVA and MS increases, while IS/OS junction and defect ELM defect decreases after surgery in IMH patients. IS/OS junction defect and ELM defect after surgery were both related to sensitive and BCVA.