Retinal function as assessed by multifocal electroretinography and central perimetry before and after vitrectomy with conventional versus fovea-sparing internal limiting membrane peeling for idiopathic macular hole

Authors

  • I. Buallagui SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
  • Z. A. Rozanova SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
  • N. I. Khramenko SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
  • S. B. Slobodianyk SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
  • O. Iu. Terletska SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
  • M. M. Umanets SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"

DOI:

https://doi.org/10.31288/oftalmolzh202414453

Keywords:

vitrectomy, optical coherence tomography, idiopathic macular hole, internal limiting membrane, multifocal electroretinography, automated static perimetry

Abstract

Purpose: To perform multifocal electroretinography (mfERG)- and central perimetry-based evaluation of the function of the macula before and after vitrectomy with conventional internal limiting membrane (ILM) peeling versus fovea-sparing ILM peeling for idiopathic macular hole (IMH).

Material and Methods: This study included 70 patients (71 eyes) who received 25-G vitrectomy with conventional or fovea-sparing ILM peeling and gas tamponade with 20% SF6 or 15% С3F8 for stage-2 to stage-4 holes as per the classification by Gass. Eyes of study patients underwent optical coherence tomography angiography (OCTA) evaluation of IMH diameter and   choriocapillaris perfusion density, ten-degree static perimetry and 20-degree 5-ring mfERG before and 1 month after surgery.

Results: Before surgery, eyes with IMH showed significantly reduced foveal light sensitivity and overall parafoveal sensitivity, increased Pattern Standard Deviation (PSD), and reduced retinal response density in mfERG rings 1 and 2 compared to fellow eyes. The foveal threshold sensitivity in the affected eyes was found to be correlated with minimal diameter of IMH (r = -0.77; р < 0.05) and the postoperative BCVA (r = 0.66; р < 0.05), whereas the overall retinal sensitivity, with the maximal diameter of IMH (r = -0.56), preoperative BCVA (r = 0.6) and postoperative BCVA (r = 0.7). MfERG retinal response density in ring 1 was significantly reduced (р = 0.00001) and correlated with the preoperative foveal threshold sensitivity (r = 0.6) and choriocapillaris perfusion density (r = 0.39). After macular hole closure, median BCVA (interquartile range) in the fovea-sparing ILM peeling group and the conventional ILM peeling group improved to 0.55 (0.35–0.7) and 0.43 (0.35–0.6), respectively. In addition, the foveal threshold sensitivity within 10-degree area in the former and latter groups improved, but was 13.6% (р = 0.009) and 15% (р = 0.0001), respectively, lower than in the fellow eyes (34.5 ± 2.9 dB). The overall retinal sensitivity in the fovea-sparing ILM peeling group improved more substantially, to 509.6 ± 13.9 dB, and almost reached the fellow-eye value (528.0 ± 25.8 dB). Moreover, the retinal response density in the conventional ILM peeling group improved in rings 1-5, whereas that in the fovea-sparing ILM peeling group, in rings 2-4, but not in ring 1.

Conclusion: In eyes with IMH, retinal photoreceptor function as assessed by perimetry and mfERG was found to be impaired at baseline and improved after macular hole closure. In the fovea-sparing ILM peeling group, the overall retinal sensitivity in the affected eyes improved more substantially than in the conventional ILM peeling group.

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Published

2024-02-29

How to Cite

1.
Buallagui I, Rozanova ZA, Khramenko NI, Slobodianyk SB, Terletska OI, Umanets MM. Retinal function as assessed by multifocal electroretinography and central perimetry before and after vitrectomy with conventional versus fovea-sparing internal limiting membrane peeling for idiopathic macular hole. J.ophthalmol. (Ukraine) [Internet]. 2024 Feb. 29 [cited 2024 Apr. 22];(1):44-53. Available from: https://ua.ozhurnal.com/index.php/files/article/view/126

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Section

Clinical Ophthalmology