Multifocal Electroretinogram before and after Epiretinal Membrane Surgery

Jae Hoon Kang; Eun Su Choi; Jae Moon Yoon; Hee Sung Yoon

doi:10.3341/jkos.2008.49.1.104

Journal List > J Korean Ophthalmol Soc > v.49(1) > 1008009

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Kang, Choi, Yoon, and Yoon: Multifocal Electroretinogram before and after Epiretinal Membrane Surgery

Original Article

J Korean Ophthalmol Soc 2008;49(1):104-110.

Published online: 3 August 2008

DOI: https://doi.org/10.3341/jkos.2008.49.1.104

Multifocal Electroretinogram before and after Epiretinal Membrane Surgery

Jae Hoon Kang, M.D., Eun Su Choi, M.D., Jae Moon Yoon, M.D., Hee Sung Yoon, M.D., Ph.D.

Sungmo Eye Hospital, Pusan, Korea

Address reprint requests to Hee Sung Yoon, M.D. Ph.D. Sungmo Eye Hospital #1078-7 Woo2-dong, Haeundae-gu, Pusan 612-022, Korea Tel: 82-51-743-0775, Fax: 82-51-743-0776, E-mail: heesyoon@dreamwiz.com

Received 8 May 2007 Accepted 2 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess macular function before and after vitrectomy and membrane removal in epiretinal membranes by means of multifocal electroretinogram (mfERG).

Methods

The mfERGs (RETIscan^®, Roland, Germany) of 28 consecutive patients (28 eyes) with idiopathic epiretinal membranes were recorded before epiretinal membrane surgery and 3 to 6 months after surgery. The average retinal response density and implicit time of each local response were estimated as anatomic macular areas corresponding roughly to 5 rings. Preoperative and postoperative responses of mfERG were compared. The correlation of the change of retinal response density and postoperative macular configuration on optical coherent tomography (OCT) was statistically analyzed.

Results

The postoperative value of P1 amplitude and implicit time were not statistically correlated with the preoperative value (p>0.05). There were no significant correlations between the changes of rings 1 and 2 with regard to the retinal response density of the mfERGs and visual acuity. There was no significant correlation between the change of retinal response density and postoperative macular configuration according to OCT.

Conclusions

The use of mfERGs does not seem useful for predicting clinical prognosis after epiretinal membrane surgery. Further studies of influence of internal limiting membrane removal on mfERG response should be conducted.

Keywords: Epiretinal membrane, Macular function, Multifocal electroretinogram

References

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Figure 1.

Preoperative color fundus photograph showed thin macular epiretinal membrane (A). Internal limiting membrane was peeled off using a microforceps at an area of approximately 3 disc diameters surrounding the fovea (B).

Figure 2.

Relationship between preoperative and postoperative (A) amplitude of the ring 1, (B) amplitude of the ring 2. There are significant correlation between the two parameters (p<0.05).

Figure 3.

Preoperatvie (A) and postoperative (B) OCT (optical coherence tomography) and mfERG (multifocal electroretinogram) findings of a 56-year-old male with epiretinal membrane.

Figure 4.

Number of patients according to postoperative OCT findings of the macula.

Table 1.

Distribution of mean age, sex and visual acuity

Age (years)	63.12±5.2
M:F (Number of eyes)	13:15
Preoperative BCVA^* (log MAR)	0.75
Postoperative BCVA^* (log MAR)	0.46
Change of VA^†(lines)	3.0

^* BCVA=best-corrected visual acuity.

^† VA=visual acuity.

Table 2.

Average amplitude and implicit time of P1 according to the 8 concentric rings

		Preoperative value	Postoperative value	P value^*
Amplitude (nV/deg²)	Ring 1	57.41±27.18	60.02±34.41	0.64
	Ring 2	39.81±17.07	38.40±14.83	0.53
Implicit time (ms)	Ring 1	42.22±5.73	41.85±5.57	0.81
	Ring 2	41.85±5.57	40.94±2.19	0.40

^* P value=paired sample T-test.

Table 3.

Mean amplitude and implicit time according to change in visual acuity

Change of VA		≥10 lines		2∼9 lines		No change		Decrease		_P _value^*
Number of eyes		7		12		6		3
		Pre^†	Post^‡	Pre^†	Post^‡	Pre^†	Post^‡	Pre^†	Post^‡
Amplitude (nV/deg²)	ring 1	38.3	38.3	72.1	73.8	45.9	61.3	65.9	71.2	>0.05
	ring 2	20.6	23.8	49.3	43.2	37.9	38.7	49.7	52.3	>0.05
Implicit time (ms)	ring 1	41.3	38.2	44.0	42.9	40.4	43.0	40.4	43.4	>0.05
	ring 2	43.0	42.4	41.3	40.0	40.4	40.8	40.8	41.1	>0.05

^* P value=paired sample T-test.

^† Pre=preoperative value.

^‡ Post=postoperative value.

Table 4.

Mean amplitude, implicit time according to postoperative OCT finding of the macula

		Group 1^*		Group 2^†		Group 3^‡		P value^§
Number of eyes		7		12		6
Number of eyes		Pre^∏	Post^#	Pre^∏	Post^#	Pre^∏	Post^#
Amplitude (nV/deg²)	ring 1	73.4	82.7	61.8	58.7	43.3	49.3	>0.05
	ring 2	49.9	46.9	38.6	39.2	30.9	32.2	>0.05
Implicit time (ms)	ring 1	43.6	43.3	42.2	43.1	44.0	38.8	>0.05
	ring 2	41.1	40.4	40.6	41.7	43.1	39.5	>0.05
	ring 2	41.1	40.4	40.6	41.7	43.1	39.5	>0.05

^* Group 1=concave pattern.

^† Group 2=flat pattern.

^‡ Group 3=convex pattern.

^§ P value=paired sample T-test.

^∏ Pre=preoperative value.

^# Post=postoperative value.

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