Cone Electroretinograms in Response to Color Stimuli After Successful Retinal Detachment Surgery
Introduction
Rhegmatogenous retinal detachment can be treated successfully by scleral buckling surgery, and the rates of retinal reattachment are satisfactory. However, a discrepancy exists between anatomical repair and visual function.1 After successful retinal detachment surgery, patients are known to have a blue-yellow color vision defect.2, 3, 4 A residual defect in hue discrimination was observed 2 years after surgery in patients whose visual acuity had returned to normal levels.2 Recovery from the blue-yellow defect, as evaluated with the pseudoisochromatic test, which is sensitive for evaluating acquired color vision deficiency, was similar to that of visual acuity. The deficiency improved within 2 months to the preoperative level, with a residual defect.4 Recently, a histopathological study, using carbonic anhydrase and an antibody to an isoform of arrestin (S antigen), revealed total loss of the short wavelength sensitive (S-) cones, whereas the long (L-) and middle wavelength sensitive (M-) cones were comparatively resistant to damage.5 In this report we describe cone electroretinograms (ERGs) in response to different color flashes with a Ganzfeld stimulus in patients who had undergone successful retinal detachment surgery.
Section snippets
Subjects and Methods
Nineteen patients with unilateral rhegmatogenous retinal detachment who had successful outcomes after a single surgical procedure without epimacular proliferation and/or cystoid macular edema were studied. Their ages ranged from 18 to 64 years (M = 40.5). Patients with a history of ocular trauma or other retinal diseases were excluded from this study. All patients had undergone conventional surgical techniques of scleral buckling with cryoretinopexy and drainage of subretinal fluid. The macula
Results
Figure 1 illustrates cone ERGs in response to different chromatic stimuli in the presence of white background illumination from an operated eye and a normal fellow eye in a 38-year-old patient who underwent surgery for retinal detachment involving the macula, 2 months before the ERG study. The postoperative visual acuity was 20/40 in the operated eye. In normal eyes, the S-cone ERG elicited by short wavelength (450 and 471 nm) stimuli appears as a separate b-wave riding on an earlier mixed L-
Discussion
Several electrophysiological studies have demonstrated a gradual recovery of ERG responses after retinal detachment surgery,9, 10 with no difference reported in ERG recovery in the three-cone mechanisms. To our knowledge, our preliminary study demonstrated for the first time the relative vulnerability of the S-cone ERG in eyes after retinal detachment surgery. Although the amplitudes of b-waves originating from the three types of cones were reduced in operated eyes, as compared with normal
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