HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Terasaki, H. Articles by Kondo, M. Search for Related Content PubMed PubMed Citation Articles by Terasaki, H. Articles by Kondo, M.

Focal Macular ERGs in Eyes after Removal of Macular ILM during Macular Hole Surgery

From the Department of Ophthalmology, Nagoya University School of Medicine, Nagoya, Japan.

PURPOSE. The removal of the internal limiting membrane (ILM) for traction maculopathy has recently been advocated. However, it is generally believed that the ILM plays an important role in retinal function, because it is the basal lamina of the Müller cells that are involved in the generation of the electroretinogram (ERG) b-wave. To date, there has been no objective assessment of retinal function on removing the ILM. In this study, the changes of each component of the focal macular electroretinograms (FMERGs) were investigated in eyes before and after the ILM was removed in the macular area during surgery for idiopathic macular holes (IMHs).

METHODS. FMERGs were elicited by a 15° stimulus centered on the fovea and monitored by an infrared fundus camera. FMERGs were recorded from 49 eyes of 48 patients with IMHs before and 6 weeks after anatomically successful macular hole surgery. Whether an eye had or did not have the ILM removed was randomly determined. The ILM was removed in 30 eyes (ILM-off group) and was not removed in 19 eyes (ILM-on group). Six months after surgery, the same examination was performed in 27 eyes of the ILM-off group and in 15 eyes of the ILM-on group. The amplitudes and implicit times of the a- and b-waves and the mean amplitudes and implicit times of the first three oscillatory potentials (OP1 to OP3) were compared before and after surgery within and between the groups.

RESULTS. Visual acuity increased significantly after surgery in both groups. In the ILM-on group, the amplitude of the a- and b-waves and the OPs increased significantly 6 months after surgery (P = 0.0093, P = 0.0019, P = 0.0024, respectively, paired t-test). In the ILM-off group, the a-wave amplitude and mean OP amplitudes were significantly larger 6 months after surgery (P = 0.0077, P = 0.0030, respectively, paired t-test). The b-wave amplitude, however, did not change significantly. The percentage increase in the b-wave amplitude 6 months after surgery was significantly higher in the ILM-on group (44.0%) than in the ILM-off group (15.0%; P = 0.037, t-test).

CONCLUSIONS. The removal of the ILM had no adverse effect on visual acuity. However, the selective delay of recovery of the FMERG b-wave 6 months after surgery suggests an alteration of retinal physiology in the macular region.

This article has been cited by other articles:

				R Tadayoni, A Gaudric, B Haouchine, and P Massin Relationship between macular hole size and the potential benefit of internal limiting membrane peeling Br. J. Ophthalmol., October 1, 2006; 90(10): 1239 - 1241. [Abstract] [Full Text] [PDF]

				D. Li, M. Horiguchi, and S. Kishi Tomographic and Multifocal Electroretinographic Features of Idiopathic Epimacular Membranes Arch Ophthalmol, October 1, 2004; 122(10): 1462 - 1467. [Abstract] [Full Text] [PDF]

				J.-D. Ho, H.-C. Chen, S.-N. Chen, and R. J.-F. Tsai Reduction of Indocyanine Green-Associated Photosensitizing Toxicity in Retinal Pigment Epithelium by Sodium Elimination Arch Ophthalmol, June 1, 2004; 122(6): 871 - 878. [Abstract] [Full Text] [PDF]

				H. Terasaki, T. Kojima, H. Niwa, C.-H. Piao, S. Ueno, M. Kondo, Y. Ito, and Y. Miyake Changes in Focal Macular Electroretinograms and Foveal Thickness after Vitrectomy for Diabetic Macular Edema Invest. Ophthalmol. Vis. Sci., October 1, 2003; 44(10): 4465 - 4472. [Abstract] [Full Text] [PDF]

				J.-D. Ho, R. J.-F. Tsai, S.-N. Chen, and H.-C. Chen Cytotoxicity of Indocyanine Green on Retinal Pigment Epithelium: Implications for Macular Hole Surgery Arch Ophthalmol, October 1, 2003; 121(10): 1423 - 1429. [Abstract] [Full Text] [PDF]

				R Uemoto, S Yamamoto, T Aoki, I Tsukahara, T Yamamoto, and S Takeuchi Macular configuration determined by optical coherence tomography after idiopathic macular hole surgery with or without internal limiting membrane peeling Br. J. Ophthalmol., November 1, 2002; 86(11): 1240 - 1242. [Abstract] [Full Text] [PDF]