Preoperative electroretinogram and postoperative visual outcome in patients with diabetic vitreous hemorrhage.
OBJECTIVE
To determine whether the single-flash electroretinogram (ERG) can predict the postoperative outcome in diabetic cases where massive vitreous hemorrhage precludes fundus observation.


METHODS
Eighty-five diabetic patients (105 eyes) who underwent vitrectomy due to dense vitreous hemorrhage were studied retrospectively. Eyes with postoperative complications were excluded. Preoperative ERGs (mixed cone-rod ERG with maximum flash intensity) were classified as: Group A, the b-wave/a-wave ratio (b/a ratio) was > or =1.0 and the oscillatory potentials (OPs) were clearly recordable (22 eyes); Group B, the b/a ratio was > or =1.0 and the OPs were markedly reduced (33 eyes); and Group C, the b/a ratio was <1.0 (50 eyes).


RESULTS
The postoperative visual acuity in Group C (hand motion to 1.5) was significantly worse than in Group A (0.4-.2) (P<.01) or Group B (0.08-1.0) (P<.01). Thick preretinal membrane causing retinal traction around the optic disc was found intraoperatively in 1 eye (4.5%) in Group A, 9 eyes (27.3%) in Group B, and 28 eyes (56.0%) in Group C (P=.0132).


CONCLUSIONS
Our findings suggested that the configuration of the single-flash ERG can provide important preoperative information for a functional prognosis following vitrectomy in diabetic patients with vitreous hemorrhage.
Hiraiwa
Takashi
T
Department of Ophthalmology, Nagoya University School of Medicine, Nagoya, Japan
Horio
Naoichi
N
Terasaki
Hiroko
H
Suzuki
Toshimitsu
T
Yamamoto
Etsuko
E
Horiguchi
Masayuki
M
Miyake
Yozo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D004596:Electroretinography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D020419:Photoreceptor Cells, Vertebrate / Q000502:physiology*; D019106:Postoperative Hemorrhage; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery