Abstract
Purpose :
To provide evidence on the functional improvement of the macula from multifocal electroretinography (mfERG) following L-shaped macular buckle implantation for patients with macular hole retinal detachment and foveoschisis foveal detachment.
Methods :
Five eyes from five patients with myopic macular hole retinal detachment (MHRD) or foveoschisis foveal detachment (FSFD) underwent L-shaped macular buckling surgery. The mean mfERG amplitudes of first- and second-order kernel responses were compared with five control eyes and between the preoperative and postoperative recordings in MHRD/ FSFD eyes. Correlation analysis between mfERG response amplitudes, OCT parameters and visual acuity were performed.
Results :
The preoperative mfERG from myopic MHRD/ FSFD patients had significantly lower first-order kernel response amplitudes in ring 1 to ring 3 (p=0.016) and second-order kernel P1 amplitude in all rings (p≤0.032) and N1 amplitude of ring 1 to 4 (p=0.016) compared with controls. After L-shaped macular buckling surgery, the mfERG showed significant improvement in first-order mfERG P1 amplitude at month 3 postoperatively (P<0.05), and first-order P1, N1 and second-order N1 amplitudes at month 6 postoperatively (P<0.05). The patients all recovered their mfERG amplitudes in a similar pattern. Namely, the more peripheral macula responses recover before the central response despite the OCT showing anatomical improvement of the entire macula following surgery. A correlation analysis showed a significant correlation between visual acuity and second-order amplitudes of ring 2 (p<0.005).
Conclusions :
After successful myopic MHRD / FSFD surgery, the functional improvement starts from the peripheral macula and progresses inwards towards the fovea. The inner retina recovers slower than the outer retina and visual acuity correlated with the severity of paracentral inner macular dysfunction on mfERG.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.