The electroretinogram photopic negative response of idiopathic macular hole (stage 2) by vitrectomy with or without internal limiting membrane peeling_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhu Yuanfei ,  Zhao Tieying , Cheng Hongbo

Shenzhen Eye Hospital, Affiliated Shenzhen Eye Hospital of Jinan University, Joint College of Optometry of Shenzhen University, Shenzhen Key Laboratory of Ophthalmology, Ocular Trauma Treatment and Stem Cell Differentiation Public Service Platform of Shenzhen, Shenzhen 518040, China(Zhao Tieying, now working at the Huaxia Eye Hospital of Huaxia Eye Group);

Corresponding author：

Zhao Tieying, Email: zhaotieying2007@hotmail.com

Keywords：

Retinal perforations/surgery; Vitrectomy; Electroretinography

DOI：

10.3760/cma.j.issn.1005-1015.2017.04.009

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ObjectiveTo observe the electroretinogram (ERG) photopic negative response (PhNR) of idiopathic macular hole (IMH) in stage 2 by vitrectomy with or without internal limiting membrane peeling (ILMP).MethodsTwenty-three stage 2 IMH patients (23 eyes) were enrolled in this prospective study. All patients received the best corrected visual acuity (BCVA), optical coherence tomography and flash-ERG examinations. The patients were randomly divided into group A (11 eyes, vitrectomy) and B (12 eyes, vitrectomy with ILMP). There was no significant difference in BCVA (t=0.96, P=0.350), diameter of macular hole (MH) (t=3.21, P=0.580) and the PhNR amplitude (t=0.98, P=0.353) in group A and B. All patients underwent 25G vitrectomy, ILMP was carried out in group B. The follow-up time was 3 to 6 months, with the mean follow-up time of 4.3 months. BCVA, MH closure rate and PhNR amplitude in group A and B were analyzed before and after surgery.ResultsThree months after surgery, 10 eyes (90.9%) gained MH closure but 1 eye (9.1%) failed in group A. In group B, 12 eyes (100.0%) gained MH closure. There was no significant difference in MH closure rate between the two groups (P=0.462). The mean BCVA of group A and B was 0.69±0.24 and 0.65±0.22, there was no significant difference between the two groups (t=0.49, P=0.722). The amplitude of PhNR in group A was (36.6±7.4) μV, which was lower than the pre-surgery PhNR, but the difference was not significant (t=0.73, P=0.472). The amplitude of PhNR in group B was (27.1±12.4) μV, which was lower than that the pre-surgery PhNR, and the difference was significant (t =3.56, P =0.002). The difference of PhNR amplitude in group A and B was statistically significant (t=2.17, P=0.042).ConclusionCompared with non-ILMP, vitrectomy combined with ILMP will significantly reduce the PhNR amplitude of IMH in stage 2.

Citation： Zhu Yuanfei, Zhao Tieying, Cheng Hongbo. The electroretinogram photopic negative response of idiopathic macular hole (stage 2) by vitrectomy with or without internal limiting membrane peeling. Chinese Journal of Ocular Fundus Diseases, 2017, 33(4): 364-367. doi: 10.3760/cma.j.issn.1005-1015.2017.04.009 Copy

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5.	朱远飞, 赵铁英. 视网膜内界膜及其剥除术治疗特发性黄斑裂孔作用[J]. 中国实用眼科杂志, 2011, 29(1): 10-13. DOI: 10.3760/cma.j.issn.1006.4443.2011.01.004.Zhu YF, Zhao TY.Internal limiting membrane and internal limiting membrane peeling in idiopathic macular hole treatment [J]. Chin J Pract Ophthalmol, 2011, 29(1): 10-13. DOI: 10.3760/cma.j.issn.1006.4443.2011.01.004.
6.	McCulloch DL, Marmor MF, Brigell MG, et al. ISCEV standard for full-field clinical electroretinography [J]. Doc Ophthalmol, 2015, 130(1): 1-12. DOI10.1007/s10633-014-9473-7.
7.	俞晓艺, 杨安怀, 邢怡桥, 等. 特发性黄斑裂孔手术前后的视力、多焦视网膜电图及光相干断层扫描的变化分析[J]. 中华眼底病杂志, 2004, 20(4): 221-225.Yu XY, Yang AH, Xing YQ, et al. Analysis of changes of visual acuity, multifocal electroretinogram and optical coherence tomogram before and after successful idiopathic macular hole surgery[J]. Chinese J Ocular fundus Dis, 2004, 20(4): 221-225.
8.	Wong D. To peel or not to peel the internal limiting membrane: a question finally answered?[J]. Br J Ophthalmol, 2009, 93(8): 987-988. DOI: 10.1136/bjo.2008.156521.
9.	Kinoshita J, Takada S, Iwata N, et al. Comparison of photopic negative response (PhNR) between focal macular and full-field electroretinograms in monkeys[J]. Doc Ophthalmol, 2016, 132(3): 177-187. DOI: 10.1007/s10633-016-9538-x.
10.	Takamura Y, Tomomatsu T, Matsumura T, et al. Correlation between central retinal thickness after successful macular hole surgery and visual outcome[J] Jpn J Ophthalmol, 2015, 59(6): 394-400. DOI: 10.1007/s10384-015-0406-0.
11.	Scupola A, Mastrocola A, Sasso P, et al. Assessment of retinal function before and after idiopathic macular hole surgery[J]. Am J Ophthalmol, 2013, 156(1): 132-139. DOI: 10.1016/j.ajo.2013.02.007.

1. Rahimy E, McCannel CA.Impact of internal limiting membrane peeling on macular hole reopening [J]. Retina, 2016, 36(4): 679-687. DOI: 10.1097/IAE.0000000000000782.
2. 朱远飞, 赵铁英. 特发性黄斑裂孔的治疗进展[J]. 中华眼底病杂志, 2015, 31(4): 323-325. DOI: 10.3760/cma.j.issn.1005-1015.2015.04.027.Zhu YF, Zhao TY. Development of treatment for idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2015, 31(4): 323-325. DOI: 10.3760/cma.j.issn.1005-1015.2015.04.027.
3. Woon WH, Greig D, Savage MD, et al. Asymmetric vitreomacular traction and symmetrical full thickness macular hole formation [J]. Graefe’s Arch Clin Exp Ophthalmol, 2015, 253(11): 1851-1857. DOI: 10.1007/s00417-014-2884-z.
4. Chhablani J, Kumar K, Ali TR, et al.Spectral-domain optical coherence tomography features in fellow eyes of patients with idiopathic macular hole[J]. Eur J Ophthalmol, 2014, 24 (3): 382-386. DOI: 10.5301/ejo.5000386.
5. 朱远飞, 赵铁英. 视网膜内界膜及其剥除术治疗特发性黄斑裂孔作用[J]. 中国实用眼科杂志, 2011, 29(1): 10-13. DOI: 10.3760/cma.j.issn.1006.4443.2011.01.004.Zhu YF, Zhao TY.Internal limiting membrane and internal limiting membrane peeling in idiopathic macular hole treatment [J]. Chin J Pract Ophthalmol, 2011, 29(1): 10-13. DOI: 10.3760/cma.j.issn.1006.4443.2011.01.004.
6. McCulloch DL, Marmor MF, Brigell MG, et al. ISCEV standard for full-field clinical electroretinography [J]. Doc Ophthalmol, 2015, 130(1): 1-12. DOI10.1007/s10633-014-9473-7.
7. 俞晓艺, 杨安怀, 邢怡桥, 等. 特发性黄斑裂孔手术前后的视力、多焦视网膜电图及光相干断层扫描的变化分析[J]. 中华眼底病杂志, 2004, 20(4): 221-225.Yu XY, Yang AH, Xing YQ, et al. Analysis of changes of visual acuity, multifocal electroretinogram and optical coherence tomogram before and after successful idiopathic macular hole surgery[J]. Chinese J Ocular fundus Dis, 2004, 20(4): 221-225.
8. Wong D. To peel or not to peel the internal limiting membrane: a question finally answered?[J]. Br J Ophthalmol, 2009, 93(8): 987-988. DOI: 10.1136/bjo.2008.156521.
9. Kinoshita J, Takada S, Iwata N, et al. Comparison of photopic negative response (PhNR) between focal macular and full-field electroretinograms in monkeys[J]. Doc Ophthalmol, 2016, 132(3): 177-187. DOI: 10.1007/s10633-016-9538-x.
10. Takamura Y, Tomomatsu T, Matsumura T, et al. Correlation between central retinal thickness after successful macular hole surgery and visual outcome[J] Jpn J Ophthalmol, 2015, 59(6): 394-400. DOI: 10.1007/s10384-015-0406-0.
11. Scupola A, Mastrocola A, Sasso P, et al. Assessment of retinal function before and after idiopathic macular hole surgery[J]. Am J Ophthalmol, 2013, 156(1): 132-139. DOI: 10.1016/j.ajo.2013.02.007.

Chinese Journal of Ocular Fundus Diseases

The electroretinogram photopic negative response of idiopathic macular hole (stage 2) by vitrectomy with or without internal limiting membrane peeling

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