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K. E. Holm, M. Lovestam-Adrian, S. Andreasson; Evaluation of Structure and Retinal Function in Longstanding Rhegmatogenous Detachment After Vitreoretinal Surgery Including Retinectomy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6075.
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To evaluate the outcome of standardized retinectomy in patients with longstanding retinal detachment, with mfERG, ERG and OCT
4 patients with a history of visual field loss of at least one month, were included in this study. Clinical examination, Optical Coherence Tomography (OCT), multifocal electroretinography (MFERG) and full field electroretinography (ffERG) were performed within 1-5 days before surgery and at least 3 months after siliconoil removal. All patients underwent the same primary surgery; three-port pars plana vitrectomy, 120-180 degrees retinectomy, fluid-air exchange, laser and 5000 cskt siliconoil.The research procedures were performed in accordance with the Declaration of Helsinki
Preoperatively OCT showed detached macula and mfERG was ND (non detectable) in all eyes. The combined rod/cone response, in the ffERG, was ND in two eyes and reduced with more than 60% in the other two eyes,compared to normals. 30 Hz flicker,reflecting the separate cone response, also demonstrated reduction with more than 60 % in three eyes and ND in one eye. Follow up time was 8-45 months.After silicon oil removal the retina was attached in all eyes; in 3 eyes after 1 surgery.Postoperatively, OCT demonstrated attached macula. In the central area the mfERG amplitudes and implicit times were 5.4-11.8 nV/deg2 and 28.3-37.5ms respectively. The combined rod/cone and the 30 Hz flicker amplitudes improved, but didn't reach normal levels.
In eyes with longstanding retinal detachment and no detectable macular function, the central and peripheral function can improve after vitreoretinal surgery including retinectomy. Evaluation with OCT, mfERG and ffERG, in this group of patients, enhance our possibility to further understand the recovery process of structure and function of central and peripheral retina.
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