A Multifocal Electroretinography Study to Evaluate Risk of Developing Macular Hole in the Fellow Eye of Patients Suffering with Unilateral Macular Hole

Overview

Journal Ther Adv Ophthalmol

Specialty Ophthalmology

Date 2020 Mar 11

PMID 32154503

Authors

Daleena Dalan

Durgasri Jaisankar

Karthiga Mani

Abinaya Madhu

Dhanashree Ratra

Affiliations

Soon will be listed here.

Abstract

Background: Visual outcome of eyes has often been found to be unsatisfactory even after successful closure of a macular hole, owing to factors like persistent metamorphopsia, scotoma, and reduced sensitivity. Therefore, it becomes critical to evaluate and study the probability and risk of developing a macular hole in the fellow eyes of the patient. This study analyzed the multifocal electroretinographic responses to help predict the risk of macular hole development in fellow eyes.

Methods: In total 26 fellow eyes, 26 eyes with macular hole, and 50 eyes of 25 controls were enrolled prospectively. The retinal responses from the different rings were compared in the three groups. Optical coherence tomography was done to rule out macular pathology or vitreomacular traction in the fellow eyes.

Results: All the fellow eyes under observation showed significantly reduced mean amplitudes of retinal response densities, in all rings as compared with controls (31.45 ± 10.38 48.87 ± 7.55, = 0.00). Three of the fellow eyes developed a macular hole during the 24 months observation period. The prevalence of fellow eye involvement was 11.5%. Relative risk of developing macular hole in the fellow eye ranged from 25 to 75.

Conclusion: All the fellow eyes, including those that did not develop a macular hole, showed significantly reduced responses on multifocal electroretinogram. This indicates that macular hole may not be a focal disease. It may have widespread functional deficit which is bilateral in nature and suggestive of a degenerative or ischemic insult.

References

Klaas J, Burzer S, Abraham S, Feucht N, Lohmann C, Maier M . [Morphology of the vitreoretinal interface in fellow eyes of patients with full thickness macular holes]. Ophthalmologe. 2017; 115(12):1050-1055. DOI: 10.1007/s00347-017-0614-8. View

Birch D, Jost B, Fish G . The focal electroretinogram in fellow eyes of patients with idiopathic macular holes. Arch Ophthalmol. 1988; 106(11):1558-63. DOI: 10.1001/archopht.1988.01060140726043. View

Terasaki H, Miyake Y, Nomura R, Piao C, Hori K, Niwa T . Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery. Invest Ophthalmol Vis Sci. 2001; 42(1):229-34. View

Andreasson S, Ghosh F . Cone implicit time as a predictor of visual outcome in macular hole surgery. Graefes Arch Clin Exp Ophthalmol. 2014; 252(12):1903-9. DOI: 10.1007/s00417-014-2628-0. View

Lewis M, Cohen S, Smiddy W, GASS J . Bilaterality of idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol. 1996; 234(4):241-5. DOI: 10.1007/BF00430416. View

Hee M, Puliafito C, Wong C, Duker J, Reichel E, Schuman J . Optical coherence tomography of macular holes. Ophthalmology. 1995; 102(5):748-56. DOI: 10.1016/s0161-6420(95)30959-1. View

Nava U, Cereda M, Bottoni F, Preziosa C, Pellegrini M, Giani A . Long-term follow-up of fellow eye in patients with lamellar macular hole. Graefes Arch Clin Exp Ophthalmol. 2017; 255(8):1485-1492. DOI: 10.1007/s00417-017-3652-7. View

Szlyk J, Vajaranant T, Rana R, Lai W, Pulido J, Paliga J . Assessing responses of the macula in patients with macular holes using a new system measuring localized visual acuity and the mfERG. Doc Ophthalmol. 2005; 110(2-3):181-91. DOI: 10.1007/s10633-005-4313-4. View

Bronstein M, Trempe C, Freeman H . Fellow eyes of eyes with macular holes. Am J Ophthalmol. 1981; 92(6):757-61. DOI: 10.1016/s0002-9394(14)75625-9. View

10.

S Dimopoulos I, Tennant M, Johnson A, Fisher S, Freund P, Sauve Y . Subjects with unilateral neovascular AMD have bilateral delays in rod-mediated phototransduction activation kinetics and in dark adaptation recovery. Invest Ophthalmol Vis Sci. 2013; 54(8):5186-95. DOI: 10.1167/iovs.13-12194. View

11.

Kay C, Pavan P, Small L, Zhang T, Zamba G, Cohen S . Familial trends in a population with macular holes. Retina. 2011; 32(4):754-9. DOI: 10.1097/IAE.0b013e3182252a92. View

12.

Fisher Y, Slakter J, Yannuzzi L, Guyer D . A prospective natural history study and kinetic ultrasound evaluation of idiopathic macular holes. Ophthalmology. 1994; 101(1):5-11. DOI: 10.1016/s0161-6420(94)31356-x. View

13.

Nangia V, Jonas J, Khare A, Lambat S . Prevalence of macular holes in rural central India. The Central India Eye and Medical Study. Graefes Arch Clin Exp Ophthalmol. 2012; 250(7):1105-7. DOI: 10.1007/s00417-012-1933-8. View

14.

Chung H, Lee K, Hwang D, Park Y, Sohn J . PREDICTION OF MORPHOLOGIC DETERIORATION IN PATIENTS WITH LAMELLAR MACULAR HOLES. Retina. 2016; 36(9):1699-706. DOI: 10.1097/IAE.0000000000000997. View

15.

Apostolopoulos M, Koutsandrea C, Moschos M, Alonistiotis D, Papaspyrou A, Mallias J . Evaluation of successful macular hole surgery by optical coherence tomography and multifocal electroretinography. Am J Ophthalmol. 2002; 134(5):667-74. DOI: 10.1016/s0002-9394(02)01700-2. View

16.

Si Y, Kishi S, Aoyagi K . Assessment of macular function by multifocal electroretinogram before and after macular hole surgery. Br J Ophthalmol. 1999; 83(4):420-4. PMC: 1722994. DOI: 10.1136/bjo.83.4.420. View

17.

Marmor M, Tan F . Central serous chorioretinopathy: bilateral multifocal electroretinographic abnormalities. Arch Ophthalmol. 1999; 117(2):184-8. DOI: 10.1001/archopht.117.2.184. View

18.

Moschos M, Apostolopoulos M, Ladas J, Theodossiadis P, Malias J, Moschou M . Multifocal ERG changes before and after macular hole surgery. Doc Ophthalmol. 2001; 102(1):31-40. DOI: 10.1023/a:1017507220510. View

19.

Gerth C . The role of the ERG in the diagnosis and treatment of Age-Related Macular Degeneration. Doc Ophthalmol. 2008; 118(1):63-8. DOI: 10.1007/s10633-008-9133-x. View

20.

Ezra E, Wells J, Gray R, Kinsella F, Orr G, Grego J . Incidence of idiopathic full-thickness macular holes in fellow eyes. A 5-year prospective natural history study. Ophthalmology. 1998; 105(2):353-9. DOI: 10.1016/s0161-6420(98)93562-x. View