Preoperative and postoperative assessment by multifocal electroretinography in the management of optic disc pits with serous macular detachment

Abstract

Purpose To evaluate the macular function by means of multifocal electroretinogram (MF ERG) in eyes with congenital optic disc pit and serous macular detachment. The evaluation was performed before and after the successful surgical intervention. Design Nonrandomized, comparative (self-controlled), interventional trial. Participants Ten patients (10 eyes) with optic disc pit with serous macular detachment were treated with the macular buckling procedure and followed up from March 1999 through May 2001. Methods In all patients included in the study, MF ERG was recorded before and after treatment. For recording, the VERIS III system (Visual Evoked Response Imaging System; Tomey, Nagoya, Japan) was used. Main outcome measures The retinal response densities were studied before and after treatment in areas 1 and 2 and were compared with visual acuity. Results The MF ERG before treatment showed decreased retinal response densities in all 10 cases. Twelve months after the surgical intervention, the electrical response densities in areas 1 (foveal area) and 2 (parafoveal area) improved. Further improvement was noted in 3 of the 10 patients who completed a follow-up of 18 months after treatment. In 8 of the 10 patients, postoperative visual acuity also increased. In the remaining two patients, visual acuity did not change after treatment, despite improvement of the retinal response densities. Conclusions In eyes with congenital optic disc pit with serous macular detachment, the decrease in retinal electrophysiologic response before treatment was not limited to the fovea, but also involved the perifoveal area. In all 10 eyes 12 months after treatment, the electrical activities in areas 1 and 2 improved. This improvement was not always followed by an increase in visual acuity. In 2 of the 10 patients, visual acuity remained unchanged. The values of retinal response densities before treatment cannot be used alone as a prognostic factor for the postoperative functional retinal results. It should also be stressed that the results of this study cannot be compared with the results of studies where spontaneous resolution of the macular detachment occurred.