Abstract
Purpose:To determine 1) which components of retinal function are impaired after rhegmatogenous retinal detachment, 2) which outer retinal pathways (rod- or cone-driven) are more severely affected, and 3) whether there is concomitant inner retinal dysfunction.Methods:We conducted a prospective observational study in a large academic institution. We performed preoperative electroretinography on eight patients to assess outer and inner retinal function. In all cases, a comparison between the eye with the detached retina and the control fellow eye was made.Results:Eyes with a detached retina had significantly lower a-wave and b-wave amplitudes with respect to both rod- and cone-dominated testing parameters (P < 0.05) and reduced 30 Hz flicker responses compared to fellow eyes (P < 0.05); the effect size was similar for all significantly reduced parameters (r~0.6). There were no significant differences between eyes with detached retinas and control fellow eyes with respect to b/a-wave ratios, a-wave latencies, or b-wave latencies.Conclusion:Patients with rhegmatogenous retinal detachment have preoperative outer retinal dysfunction equally affecting both rod- and cone-driven pathways, and they have minimal inner retinal dysfunction.
Highlights
IntroductionThere are three types of detachments: 1) exudative retinal detachment, associated with inflammation and neoplasms; 2) tractional retinal detachment, often secondary to proliferative diabetic retinopathy; and 3) rhegmatogenous retinal detachment (RRD)
Patients were excluded if they had any retinal pathology in either eye that might confound ERG assessment, including severe diabetic or hypertensive retinopathy; advanced age‐related macular degeneration (AMD); active retinitis or uveitis; extensive retinal scarring from any cause; proliferative vitreoretinopathy of any grade; presence of detachment or history of detachment in the fellow eye; previous detachment in the study eye; history of rheumatologic or autoimmune disease; advanced glaucoma; or any form of severe media opacity
We observed deficits in the cone photoreceptor‐driven pathway that was manifested both as a decrease in a‐ and b‐wave amplitudes in response to the 3.0 cd·s/m2 light under 30 cd/m2 background illumination (Z = −2.380, P = 0.017; Z = −2.240, P = 0.025; respectively) [Figure 2a and b] and as a decrease in the 30 Hz flicker amplitudes (Z = −2.380, P = 0.017) [Figure 2c]. These findings suggest that RRD causes dysfunction of both rod‐ and cone‐driven pathways
Summary
There are three types of detachments: 1) exudative retinal detachment, associated with inflammation and neoplasms; 2) tractional retinal detachment, often secondary to proliferative diabetic retinopathy; and 3) rhegmatogenous retinal detachment (RRD). RRD is the most common form of retinal detachment, and is caused by vitreous separation with associated traction that leads to a tear in the.
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