Correlation between multifocal electroretinogram and optical coherence tomography findings with visual acuity after vitrectomy surgery for retinal detachment: an observational study

Abstract

Background: Despite the marked increase in the anatomical success rates of macula-off rhegmatogenous retinal detachment (RRD) surgery, patients may still complain about unsatisfactory visual outcome. This study aims to correlate the postoperative corrected distance visual acuity (CDVA) with the mf-ERG (multifocal electroretinogram) and OCT (optical coherence tomography) findings following vitrectomy surgery for RRD.

Patients and methods: This retrospective observational study included 40 eyes of 40 patients who underwent successful vitrectomy surgery for macula-off RRD. CDVA, mf-ERG amplitudes, mf-ERG latencies, the central macular thickness (CMT) and the integrity of the inner segment/outer segment (IS/OS) junction assessed by OCT, were evaluated 6 months postoperatively. The correlations between CDVA with mf-ERG amplitudes, mf-ERG latencies, central macular thickness, and IS/OS junction integrity were analyzed.

Results: There was a statistically significant moderate positive correlation between CDVA of the studied eyes with mf-ERG amplitudes of N1, P1 and N2 in ring 1 (P = 0.008; P < 0.001 and P = 0.004, respectively), CMT (P < 0.001), and the integrity of IS/OS junction (P < 0.001). There was no significant correlation between CDVA and mf-ERG latencies in ring 1 (P > 0.05). Linear regression analysis revealed that CDVA was significantly associated with mf-ERG amplitudes and the IS/OS junction integrity. In addition, there was a strong positive correlation between mf-ERG amplitudes in ring 1 and the IS/OS junction integrity.

Conclusions: The integrated interpretation of postoperative CDVA, multifocal ERG parameters, and OCT findings provides useful information about functional visual recovery and retinal microstructural changes following vitrectomy for macula-off RRD surgery. The positive correlation between the IS/OS junction integrity and the mf-ERG amplitudes was stronger than the correlation between the IS/OS junction integrity and CDVA suggesting that mf-ERG may be superior to CDVA in reflecting the extent of microstructural damage in the photoreceptor layer.

Trial registration: Clinicaltrials.gov, NCT05993208. Registered 15 August 2023 - Retrospectively registered, https://classic.

Clinicaltrials: gov/ct2/show/NCT05993208 .

Keywords: CDVA; OCT; Retinal detachment; Vitrectomy; mf-ERG.

Fig. 1

A demonstrative diagram showing the anatomic location of the 5 rings of mf-ERG stimuli projected onto the fundus. (mf-ERG: multifocal Electroretinogram)

Fig. 2

Grades of IS/OS junction integrity and their corresponding mf-ERG, 6 months postoperatively. A: normal IS/OS junction (OCT image-left) (yellow arrow head), trace array (middle) and 3-D topography (right) obtained from a 25-year-old male patient; B: moderately disrupted IS/OS junction (OCT image-left) (yellow arrow head), trace array (middle) and 3-D topography (right) obtained from a 49-year-old male patient; C: completely disrupted IS/OS junction (OCT image-left) (yellow arrow head), trace array (middle) and 3-D topography (right) obtained from a 45-year-old female patient. (OCT: optical coherence tomography; IS/OS: Inner segment/outer segment)

Fig. 3

Correlation between 6-month postoperative CDVA with mf-ERG amplitudes of N1, P1, N2 in ring 1. (CDVA: Corrected distance visual acuity; mf-ERG: multifocal Electroretinogram)

Fig. 4

Correlation between 6-month postoperative CDVA and CMT. (CDVA: Corrected distance visual acuity; CMT: Central macular thickness)

Fig. 5

Correlation between 6-month postoperative CDVA and the IS/OS junction integrity. (CDVA: Corrected distance visual acuity; IS/OS: Inner segment/outer segment)