Macular Function Recovery after Retinal Detachment Surgery by Multifocal Electroretinography

Abstract

Abstract: : Purpose: To evaluate macular function recovery after retinal detachment surgery by multifocal electroretinography (m-ERG). Methods: Patients with primary reghmatogenous retinal detachment with macular involvement treated with scleral buckling (SB) were recruited for this prospective study. We use a RETI-scan device and stimulated by an ELSA 20"-VGA-monitor. A 61 hexagons resolution within a 30 deg. visual field was used. Each hexagon alternate between black and white in a modified binary m-sequence at 75 Hz. The maximum luminance was 200 cd/m², the minimum luminance <1 cd/m², the mean luminance was 100 cd/m². From each retinal location, the latency of the first negative peak, N1, and the amplitude from N1 due the following positive peak P1 of the first order response (K1) were obtained. Two concentric rings averages around the foveal response were analyzed. The results were compared in each case with the fellow eye to evaluate macular recuperation. Optical coherence tomography (OCT) was done. Best-corrected visual acuity (BCVA) was obtained in each visit (1st, 3rd. and 6th. month). Results: We evaluated fifteen eyes with retinal detachment. 53% of the patients were males. Mean age was 46.6 years. (range 7- 81). The preoperative refractive error in the affected eye was -2.72 D (range + 0.75 to - 11.50 D) and the other eye was -2.57 D (range +2.00 to – 13.75 D). Most of the patients had 30 days or more of macular detachment. In the first month posterior to surgery the b-wave amplitude in the first ring gained 54.05% and in the second ring b-wave amplitude showed a 50.05% gain compared with the fellow eye. The mean thickness measured by OCT at the first month postoperatively was 231.75µ. At the third month the electrical function in the first ring b-wave amplitude recovered up to 85.61% and to 66% on the second ring in the macular area. Average visual acuity (logMAR) at first month was –1.18 and at the third month was 0.8. Conclusions: Our data suggests that there is a recovery of the electrical macular response in the first three months postoperative.

Keywords: electrophysiology: clinical • retinal detachment • macula/fovea