Electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in age related maculardegeneration

Aim - To evaluate electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in pa tients with age related macular degeneration (AMD). Methods - A consecutive series of 32 patients suffering from subfoveal chor oidal neovascularisation secondary to AMD underwent 360 degrees retinotomy and macular translocation. The ERG served as the main parameter of the stud y and was recorded I day before the translocation surgery and no earlier th an 4 weeks after the silicone oil removal. Results - The scotopic ERG amplitudes were significantly reduced after tran slocation surgery. Depending on the applied flash luminance the mean b-wave amplitude reduction of the scotopic ERG varied between 67% (0.2 cd.s/m(2)) and 74% (0.03 cd.s/m(2)). The a-waves and b-waves of the saturating light response decreased Significantly by 46% and 59%, respectively. The photopic a-wave and b-wave amplitudes were significantly lower after the translocat ion surgery resulting in a mean reduction of 27% and 43%, respectively. Conclusions - Although macular translocation may provide the potential of p reserving and even restoring vision in patients with subfoveal choroidal ne ovascular membranes secondary to AMD the present study indicates that a sig nificant electrophysiological decrease is caused by surgical procedures ass ociated with this technique. Further research is necessary to clarify if ce rtain modifications of the surgical procedure are able to substantially red uce the neuroretinal trauma.