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Predictive value of pattern VEP, pattern ERG and hole size in macular hole surgery
M A Tilanus1, M H Cuypers, N A Bemelmans
1Institute of Ophthalmology, University Hospital Nijmegen, The Netherlands. m.tilanus@chk-azn.nl
Objective:
To describe pattern-reversal visual evoked response (PRVEP) and pattern electroretinogram (PERG) parameters in eyes with macular hole and their value for predicting postoperative visual outcome.
Methods:
Prospectively we studied 27 eyes (27 patients) with a full-thickness macular hole. Preoperatively the hole and rim were measured and the PRVEP and PERG were recorded. The preoperative parameters were correlated with postoperative visual outcome.
Results:
The macular hole was closed in 26 of 27 eyes. Sixteen eyes (59%) had an increase in visual acuity (VA) of two lines or more, 10 eyes (37%) remained within one line of preoperative VA and 1 eye (4%) had a decrease in VA of two lines. Duration of symptoms was negatively correlated with preoperative VA (R=-0.547, P=0.0038) and postoperative VA (R=-0.519, P=0.0065) and positively correlated with hole area (R=0.533, P=0.0061) and rim area R=0.633, P=0.0009). Only the PRVEP P100 latency of the 10' check size and the PERG N35 latency were significantly associated with visual outcome (P=0.022 and P=0.042 respectively).
Conclusions:
There was no association of either hole or rim size with postoperative visual outcome. Preoperative electrophysiology, however, is useful as a prognostic tool. Utilization is limited to the use of latency parameters of the response and is dependent on the check size of the stimulus.