Pattern reversal electroretinograms in patients with unilateral idiopathic full thickness macular holes

PURPOSE: To discover the effect of detachment of the posterior vitreous cortex on pattern electroretinogram (PERG) P50 amplitudes in the uninvolved fellow eyes (FE) of patients with macular holes (MH), and to determine the prognostic value of the PERG in identifying the FE of patients with MH that could be at risk for the development of a MH. METHODS: PERGs were recorded using 12' and 46' checkboard stimulus reversing at 5 Hz in 18 patients selected from a cohort of 37 patients with unilateral idiopathic full thickness MH, and in age-matched controls (AMC). Contact lens biomicroscopy with a Goldmann contact lens and kinetic B-scan ultrasonography were performed bilaterally in both patients and AMC. RESULTS: The P50 amplitudes with checks of 12' and 46' were significantly lower in eyes with MH than in the uninvolved FE and AMC. There was a significant reduction in the P50 amplitudes in the FE compared to the AMC with checks of 12', but there was no significant reduction with checks of 46'. In the FE with posterior vitreous detachment (PVD) (eleven cases), the P50 amplitudes with checks of 12' were greater than in the eyes without PVD. With checks of 46', there was no significant difference in eyes with and without PVD. CONCLUSIONS: These data suggest that subclinical macular pathology in the FE of MH probably resulting from vitreous traction can be demonstrated by PERG using small check size stimulus.