Abstract
Purpose:
To study the anatomical and functional recovery after retinal detachment (RD) surgery by studying the reflectivity of the outer retina on en-face optical coherence tomography (OCT) and with multifocal electroretinogram (Mf-ERG).
Methods:
Prospective study of a consecutive series of patients successfully operated for RD and examined at baseline, at month 3 (M3) and month 6 (M6) postoperatively. At each visit, a comprehensive ophthalmologic examination was performed. A spectral-domain OCT imaging (Spectralis, Heidelberg Engineering, Heidelberg, Germany) was also obtained. The operated eyes were separated according to their macular status at baseline. At the M6 visit, en-face OCT and Mf-ERG (Metrovision, Perenchies, France) were also performed. The ISe band reflectivity was measured on C-scan in the two central degrees and correlated with the corresponding Mf-ERG results.
Results:
The group with initial macular involvement displayed decreased RMS amplitude compared to the macula on group (<2°, p<0.0001; 2°-5°, p=0.007). A reduction of the P1 wave amplitude was also found (<2 °, p = 0.03). In the central two degrees, the RMS, P1, N1 and N2 amplitudes but not implicit times were significantly correlated with the visual acuity (p <0.001). The ISe band reflectivity was lower in the macula-off group (Mann-Whitney test, p<0.05) and was correlated with the visual acuity measured at M3 and M6 visits (p<0.001). The decrease in reflectivity, suggesting a cone loss, was also correlated with the duration of the macula detachment (p=0.01). There was no relationship between the decrease of ISe reflectivity in the one hand and with the impairment of the Mf-ERG signal on the other hand.
Conclusions:
The central P1 and RMS amplitudes were the most affected Mf-ERG parameters after retinal detachment surgery. At the same time, there was a decrease in ISe band reflectivity in eyes with an initial macular involvement. The absence of relationship between these two findings suggests that the outer retina plays a limited role in the impairment of the Mf-ERG signal after retinal detachment. The implication of the inner retinal layers is currently investigated.