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Macular dysfunction in patients with macula-on rhegmatogenous retinal detachments
  1. Kunihiko Akiyama1,2,
  2. Kaoru Fujinami1,2,3,4,
  3. Ken Watanabe1,2,
  4. Toru Noda1,2,
  5. Yozo Miyake1,2,5,
  6. Kazushige Tsunoda1,2
  1. 1Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  2. 2Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  3. 3Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan
  4. 4Genetics, UCL Institute of Ophthalmology, London, UK
  5. 5Aichi Medical University, Aichi, Japan
  1. Correspondence to Dr Kunihiko Akiyama, Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo 152-8902, Japan; kakiyama{at}ntmc-hosp.jp

Abstract

Aims To assess macular function in patients with macula-on rhegmatogenous retinal detachments (RRDs) using focal macular electroretinography (FMERG).

Methods This is a prospective, observational case series of 27 patients diagnosed with a macula-on RRD. Foveal attachment was confirmed on spectral-domain optical coherence tomography. Eyes with any macular disorder, cataract, vitreous opacity or vitreous haemorrhage were excluded. FMERG was recorded in the affected and fellow eyes using a round stimulus 15° in diameter. The status of four retinal factors in the affected eyes was examined, that is, the number of involved quadrants, number of quadrants with retinal breaks, presence of an RRD invading the vascular arcade, and presence of a giant retinal tear. The implicit time and amplitude of the a-wave, b-wave and oscillatory potentials (OPs) were compared between the affected and fellow eyes using Wilcoxon signed-rank test. The influence of the four retinal factors on each FMERG component of the affected eyes was also evaluated using Mann-Whitney U test and Kruskal-Wallis test.

Results Significant reductions in the amplitudes of the a-waves (p=0.001), b-waves (p<0.001) and OPs (p=0.001) were observed in the affected eyes compared with the fellow eyes. There was no significant difference between the affected and fellow eyes in the implicit times of any components. None of the four retinal factors affected the parameters in the affected eyes.

Conclusion Altered FMERG responses suggested the presence of macular dysfunction in eyes with macula-on RRDs.

  • rhegmatogenous retinal detachment
  • macula-on
  • macular function
  • electroretinogram
  • focal macular electroretinogram.

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests KA has received lecture fees from Santen Pharmaceutical Co., Ltd. (Osaka, Japan), Bayer Japan (Osaka, Japan) and Alcon Pharma (Tokyo, Japan). KF is a paid consultant of Astellas Pharma Inc. (Tokyo, Japan) and Kubota Pharmaceutical Holdings Co., Ltd. (Tokyo, Japan). KF has received lecture fees from Santen Pharmaceutical Co., Ltd. (Osaka, Japan), Japan Ophthalmological Society (Tokyo, Japan), Japanese Retinitis Pigmentosa Society (Tokyo, Japan). TN has received lecture fees from Alcon Pharma (Tokyo, Japan), HOYA Corporation (Tokyo, Japan), Santen Pharmaceutical Co., Ltd. (Osaka, Japan), Leica Microsystems (Heerbrugg, Switzerland), and Topcon Corporation (Tokyo, Japan), and honoraria from Santen Pharmaceutical Co., Ltd. KW, KT and YM reported no competing interests.

  • Ethics approval IRB of the National Hospital Organization, Tokyo Medical Center (approval number R14-140).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.

  • Contributors Conception and design: KA, KF, YM, KT. Data collection: KA, KW. Analysis and interpretation: KA, KF, KW, TN, YM, KT. Writing the article: KA, KF, TN. Critical revision and final approval of the article: KA, KF, KW, TN, YM, KT.

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