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Macular pigment and fixation after macular translocation surgery
  1. Jens Reinhard1,
  2. Martijn J Kanis2,
  3. Tos T J M Berendschot3,
  4. Christiane Schön4,
  5. Faik Gelisken1,
  6. Susanne Trauzettel-Klosinski1,
  7. Karl U Bartz-Schmidt1,
  8. Eberhart Zrenner1
  1. 1Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
  2. 2Department of Ophthalmology, University Medical Centre, Utrecht, The Netherlands
  3. 3University Eye Clinic, Maastricht, The Netherlands
  4. 4BioTeSys GmbH, Esslingen, Germany
  1. Correspondence to Dr Jens Reinhard, Centre for Ophthalmology, Schleichstr. 12, D-72076 Tübingen, Germany; jens.reinhard{at}


Background After full macular translocation (MT) surgery with 360° retinotomy, the fovea is rarely identifiable. Our aim was to verify the position of the fovea, to determine how patients fixate after MT and to examine distribution and optical density of macular pigment (MP).

Methods 9 patients after MT were investigated. The Utrecht Macular Pigment Reflectometer was used to quantify the MP optical density. A scanning laser ophthalmoscope (SLO) was used to identify the fovea as the centre of MP distribution and determine the retinal locus of fixation.

Results In all patients, the fovea was identified as the centre of MP distribution. The retinal areas used for fixation were displayed by SLO fixation analysis. Comparing their spatial relationship with the fovea, five patients fixated centrally and four eccentrically up to 7.5°. In those patients, microperimetry showed that the atrophy caused by choroidal neovascularisation (CNV) extraction prevented central fixation.

Conclusion The combination of MP distribution and fixation analysis allows fixation behaviour to be quantified, even if the fovea morphologically cannot be localised. Our results suggest that the scotoma caused by spreading chorioretinal atrophy is the main cause for reduced visual acuity after MT, and so the MT rotation angle is crucially important.

  • Macular pigment
  • fixation
  • scanning laser ophthalmoscope
  • macular translocation
  • macula
  • neovascularisation

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  • Funding Ministry of Science, Research and Arts, Baden-Württemberg (Germany).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Ethics committee of the Tübingen University Hospital.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.