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Objectives: To develop a machine learning logistic regression algorithm that can classify patients with an idiopathic macular hole (IMH) into those with good or poor vison at 6 months after a vitrectomy. In addition, to determine its accuracy and the contribution of the preoperative OCT characteristics to the algorithm. Methods: This was a single-center, cohort study. The classifier was developed using preoperative clinical information and the optical coherence tomographic (OCT) findings of 43 eyes of 43 patients who had undergone a vitrectomy. The explanatory variables were selected using a filtering method based on statistical significance and variance inflation factor (VIF) values, and the objective variable was the best-corrected visual acuity (BCVA) at 6 months postoperation. The discrimination threshold of the BCVA was the 0.15 logarithm of the minimum angle of the resolution (logMAR) units. Results: The performance of the classifier was 0.92 for accuracy, 0.73 for recall, 0.60 for precision, 0.74 for F-score, and 0.84 for the area under the curve (AUC). In logistic regression, the standard regression coefficients were 0.28 for preoperative BCVA, 0.13 for outer nuclear layer defect length (ONL_DL), −0.21 for outer plexiform layer defect length (OPL_DL) − (ONL_DL), and −0.17 for (OPL_DL)/(ONL_DL). In the IMH form, a stenosis pattern with a narrowing from the OPL to the ONL of the MH had a significant effect on the postoperative BCVA at 6 months. Conclusions: Our results indicate that (OPL_DL) − (ONL_DL) had a similar contribution to preoperative visual acuity in predicting the postoperative visual acuity. This model had a strong performance, suggesting that the preoperative visual acuity and MH characteristics in the OCT images were crucial in forecasting the postoperative visual acuity in IMH patients. Thus, it can be used to classify MH patients into groups with good or poor postoperative visual acuity, and the classification was comparable to that of previous studies using deep learning. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical characteristics, treatment trends, and visual prognosis of submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD) and retinal arterial macroaneurysm (RAM). Methods: This retrospective study enrolled 187 Japanese patients with SMH at 10 institutions from 2015 to 2018. Medical records including SMH etiology, best-corrected visual acuity (BCVA), fundus photographs, optical coherence tomography images, and selected treatments were analyzed. Results: Major causes of SMH were typical nAMD (tnAMD) (18%), polypoidal choroidal vasculopathy (PCV) (50%) and RAM (29%). Age, male/female ratio, baseline BCVA, central retinal thickness, and involved retinal layers were significantly different between etiologies (all P<0.0001). Treatment with anti-vascular endothelial growth factor drugs with and without intravitreal gas injection was chosen for half of eyes in the tnAMD and PCV groups, whereas vitrectomy was performed in 83.7% of eyes with RAM. The final BCVA improved significantly from baseline in the PCV and RAM groups (P = 0.0009, P<0.0001) and final BCVA was significantly better in the PCV group at a level similar to the other groups (P = 0.0007, P = 0.0008). BCVA improvement from baseline was significantly greater in the RAM group compared with the tnAMD (P = 0.0152) and PCV (P = 0.017) groups. Multivariate analysis revealed better final BCVA was significantly associated with younger age (P = 0.0054), better baseline BCVA (P = 0.0021), RAM subtype (P = 0.0446), and no tnAMD (P = 0.001). Conclusions: The characteristics of, and treatment strategy for, SMH were different between the underlying diseases. Anti-vascular endothelial growth factor treatment with or without expansile gas was mainly chosen for SMH in tnAMD and PCV, whereas vitrectomy with gas was the most common treatment for RAM, and the higher rate for vitrectomy might result in the greater BCVA improvement in the RAM group than in the other groups. Final BCVA was better in PCV, RAM, and tnAMD, in that order, because patients with PCV were younger and had better baseline BCVA. [ABSTRACT FROM AUTHOR]

The development of a full-thickness macular hole (FTMH) is a rare complication of intravitreal injections, and only a small subset of eyes with an FTMH has a spontaneous closure. We report a case of repeated FTMH formations and a spontaneous closure following an intravitreal injection of bevacizumab (IVB) for a central retinal vein occlusion (CRVO). A 39-year-old male patient presented with reduced vision in his right eye and was diagnosed with a CRVO. Two months later, neovascular glaucoma and macular edema (ME) developed and IVB was performed. After 2 weeks, optical coherence tomography revealed an improvement of the ME and the formation of an FTMH with a hyperreflective material in the FTMH. Two months later, there was a recurrence of the ME and a closure of the FTMH, but the hyperreflective material was still present in the retina. Then, another IVB and panretinal photocoagulation were performed. One month later, the ME had improved and the FTMH was closed, but the hyperreflective material was still present in the retina. After another 2 months, the ME recurred and a third IVB was performed. The ME improved without a recurrence of an FTMH. After that, there were no recurrences of the ME, but the FTMH recurred with the progression of a posterior vitreous detachment and development of an epiretinal membrane 1 year after the third IVB. We suggest that an FTMH be included as a complication of intravitreal injections, and it may close spontaneously during the course of the primary disease. [ABSTRACT FROM AUTHOR]

This study's goal is to determine the accuracy of a linear classifier that predicts the prognosis of patients with macular edema (ME) due to a branch retinal vein occlusion during the maintenance phase of antivascular endothelial growth factor (anti-VEGF) therapy. The classifier was created using the clinical information and optical coherence tomographic (OCT) findings obtained up to the time of the first resolution of ME. In total, 66 eyes of 66 patients received an initial intravitreal injection of anti-VEGF followed by repeated injections with the pro re nata (PRN) regimen for 12 months. The patients were divided into two groups: those with and those without good vision during the PRN phase. The mean AUC of the classifier was 0.93, and the coefficients of the explanatory variables were: best-corrected visual acuity (BCVA) at baseline was 0.66, BCVA at first resolution of ME was 0.51, age was 0.21, the average brightness of the ellipsoid zone (EZ) was −0.12, the intactness of the external limiting membrane (ELM) was −0.14, the average brightness of the ELM was −0.17, the brightness value of EZ was −0.17, the area of the outer segments of the photoreceptors was −0.20, and the intactness of the EZ was −0.24. This algorithm predicted the prognosis over time for individual patients during the PRN phase. [ABSTRACT FROM AUTHOR]

Electroretinography (ERG) is used to evaluate the physiological status of the retina and optic nerve. The purpose of this study was to determine the usefulness of ERGs recorded with the RETeval system in diagnosing optic nerve diseases. Forty-eight patients with optic nerve disorders, including optic neuritis, ischemic optic neuropathy, traumatic optic neuropathy, and dominant optic atrophy, and 36 normal control subjects were studied. The amplitudes of the photopic negative response (PhNR) were recorded with the RETeval system without mydriasis. The circumpapillary retinal nerve fiber layer thickness (cpRNFLT) was determined by optical coherence tomography (OCT). The significance of the correlations between the PhNR and cpRNFLT parameters were determined, and the receiver operating curve (ROC) analyses were performed for the PhNR and cpRNFLT. Patients with optic nerve disorders had significantly smaller PhNRs compared to the control subjects (P = 0.001). The ROC analyses indicated that both PhNR and cpRNFLT had comparable diagnostic abilities of detecting optic nerve disorders with PhNR at 0.857 and cpRNFLT at 0.764. The PhNR components recorded with the RETeval system have comparable diagnostic abilities as the cpRNFLT in diagnosing optic nerve disorders. [ABSTRACT FROM AUTHOR]

Purpose: To describe the characteristics of Japanese patients with hydroxychloroquine (HCQ) retinopathy developing within 3 years of treatment outset. Study design: Retrospective case series Methods: Three patients with HCQ retinopathy developing within 3 years of treatment outset have been identified in Japan since HCQ became available in 2015. Their medical charts, containing optical coherence tomography (OCT), fundus autofluorescence imaging, and visual field tests, were reviewed. Results: The treatment durations and cumulative doses until onset were 29–36 months and 182–326 g, respectively. The first patient had possible pre-existing maculopathy, although the abnormalities were ambiguous. The second and third patients had impaired renal function. The patients did not complain of severe visual disturbance at diagnosis, but visual field loss and disruption of the outer retinal segments consisting of a parafoveal pattern in the first case and a pericentral pattern (localized, 8 or more degrees from the center of the fovea) in the second and third cases were clearly observed on OCT. Even after HCQ discontinuation, their retinopathy showed slight progression on the visual field tests and OCT images. A blood sample was obtained from 1 patient on the day after HCQ discontinuation, and the whole blood level of HCQ was measured using validated liquid chromatography-tandem mass spectrometry. The HCQ level 27 h after the last dose was high, at 2240 ng/mL (suggested threshold > 1733 ng/mL). Conclusion: Ophthalmologic screening from the initiation of HCQ treatment detected 3 cases of HCQ retinopathy developing within 3 years of treatment outset, including a patient with a high blood level of HCQ. [ABSTRACT FROM AUTHOR]

Purpose: The foveal bulge (FB) results from a lengthening of the outer segments of the photoreceptors which then makes the central fovea arcuate in shape. The purpose of this study was to evaluate the morphological features and locations of the FB relative to the foveal pit (FP) in a single B-scan image. Methods: One hundred and forty-seven eyes of 147 healthy volunteers were studied. Horizontal and vertical B-scan optical coherence tomographic (OCT) images through the fovea were recorded by an ultrahigh-resolution spectral domain OCT (UHR-SD-OCT) instrument (Bi-μ, KOWA, Japan). The vertex of the FB and the center of the FP were identified with the ImageJ software. The distance between the FB and FP and the height of the FB were measured. Results: In the horizontal images, the vertex of the FB was on the nasal side of the center of the FP in 97 eyes (66%), on the temporal side in 42 eyes (29%), and the same position in 8 eyes (5%). In the vertical images, the vertex of the FB was superior to the center of the FP in 82 eyes (55%), inferior to the center of the FP in 45 eyes (31%), and the same position in 20 eyes (14%). The mean distance (± SD) between the FB and the FP was + 16.8 ± 30.1 μm in the horizontal images and + 8.27 ± 28.0 μm in the vertical images. The mean height (± SD) of the FB was 77.0 ± 4.78 μm in the horizontal images and 77.9 ± 5.05 μm in the vertical images. The height of the FB in the horizontal images was significantly correlated with refractive error in the multiple regression analysis (P = 0.041). Conclusions: These results indicate that the vertex of the FB was not aligned with the center of the FP in the majority of the eyes of normal Japanese individuals in a single B-scan image. Analysis showed that eyes with less severe myopia had the higher height of the FB. This must be considered when interpreting the location of the vertex of the FB and the center of the FP in clinical situations. [ABSTRACT FROM AUTHOR]

Aim. To determine whether the area of the foveal avascular zone (FAZ), as a morphological indicator of the microcirculation of the perifoveal capillary network, changes in the carbohydrate metabolism disorders during pregnancy (the gestational age of patients with gestational diabetes mellitus (GDM) and preexisting diabetes (PexD)). Methods. Ten normal individuals and 41 eyes of 41 patients, 28 with GDM and 13 with PexD, were studied. A 3 × 3 mm area of the FAZ of the superficial capillary plexus layer (SCP) and the deep capillary plexus layer (DCP) was determined by optical coherence tomography angiography (OCTA; RS-3000 Advance, NIDEK). The significance of the correlation between the size of the FAZ and the weeks of pregnancy was determined. Results. The area of the FAZ of the SCP was 0.38 ± 0.11 mm2 (normal eyes), 0.41 ± 0.16 mm2 (GDM), and 0.43 ± 0.10 mm2 (PexD). The area of the FAZ of the DCP was 0.78 ± 0.23 mm2 (normal eyes), 0.69 ± 0.16 mm2 (GDM), and 0.79 ± 0.25 mm2 (PexD). No significant difference in the FAZ sizes was observed between the groups. The average number of weeks of pregnancy was 24.1 ± 8.2 weeks in the eyes with GDM and 23.3 ± 11.4 weeks in the eyes with PexD (P>0.05). Significant correlations were found between the size of the FAZ of the SCP and the number of weeks (r = 0.37, P=0.04 for GDM, and r = 0.49, P=0.04 for PexD, Spearman's rank-order correlation coefficient). Conclusions. For GDM and PexD under established glycemic control, the area of the FAZ is not affected, but vascular changes occurred at the early phase of pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the current clinical practice patterns of branch retinal vein occlusion (BRVO) management by retina specialists in Japan in the era of anti-vascular endothelial growth factor (VEGF) therapy. Study design: A voting survey using an answer pad system. Methods: On May 28, 2017, forty-one retina specialists were surveyed on the pathology and clinical practice of BRVO management. Results: Most specialists (77.5%) use fundus examination and optical coherence tomography (OCT) for diagnosis of macular edema (ME) secondary to BRVO. All assess the condition of the ellipsoid zone (EZ) and external limiting membrane (ELM) and consider this a visual prognostic factor. For ME secondary to BRVO, anti-VEGF therapy is the first choice, and most specialists (82.4%) select initial injection followed by a pro re nata (PRN) regimen. For switching to other treatment options for persistent cases, combination therapy of anti-VEGF injections and laser therapy is the most common choice (35.9%), whereas 25.6% select vitreous surgery and 15.4% select adding steroid injections. Conclusions: Our survey presents the current opinions on the diagnosis and treatment of BRVO by retina specialists in Japan, and reveals the common views about damage to the EZ/ELM as a factor of poor prognosis and anti-VEGF therapy as the first line treatment, highlighting various opinions on initiation and switching of therapy. [ABSTRACT FROM AUTHOR]

Purpose: A new clinical ultrahigh-resolution spectral domain optical coherence tomography (UHR-SD-OCT) system using an original averaging technique named "A-scan matching algorithm" was developed. The aim of this study was to determine whether our new UHR-SD-OCT system can obtain clearer sectional images of the retina than conventional standard resolution SD-OCT systems (SR-SD-OCT).Methods: We recorded horizontal B-scan images of 42 normal eyes using our new UHR-SD-OCT device (Bi-μ, Kowa) and a conventional SR-SD-OCT (Spectralis, Heidelberg). To evaluate the clarity of the interdigitation zone (IZ) subjectively, the integrity of IZ was divided into three types by two raters. To evaluate the clarity of the IZ objectively, a peak height score (PHS) was calculated at five different points of the macula using the longitudinal reflectivity profile.Results: The mean (± SD) of the subjective visibility score of the IZ in the UHR-SD-OCT images was 2.64 ± 0.54 which was significantly higher than the 2.46 ± 0.46 in the SR-SD-OCT images (P = 0.02). The PHS was also significantly higher for the UHR-SD-OCT than for the SR-SD-OCT images at all five locations (all P < 0.01).Conclusion: The results indicate that the newly developed clinical UHR-SD-OCT instrument using the A-scan matching algorithm can obtain clearer images of the IZ, and they suggest that this device should be clinically useful in detecting finer structural abnormalities of the outer retina. [ABSTRACT FROM AUTHOR]

Eye fatigue is a common health problem across all age groups. Herein, we explored the correlation between eye fatigue and thickness of the retinal nerve fiber layer (NFL). Included in the NFL are intrinsically photosensitive retinal ganglion cells (ipRGCs), which are associated with trigeminal pain. This retrospective cross-sectional study included outpatients with best-corrected visual acuity above 20/30 in both eyes and without dry eye, glaucoma, or retinal disease. A total of 1981 patients were initially enrolled and 377 patients were declared as eligible for the study analysis. We tested subjects for the presence of major ocular symptoms and measured thickness of ganglion cell complex (GCC) using optical coherence tomography. A total of 377 outpatients (46.4% men, mean age of 57.1 years) were enrolled for analysis, based on the interview-reported prevalence of six eye symptom, as follows: 31.5% for eye fatigue, 19.2% for blurring, 18.6% for dryness, 15.7% for photophobia, 13.5% for irritation, and 4.6% for pain. The macular GCC was significantly thicker in subjects with eye fatigue compared to the group not reporting eye fatigue (103.8 μm versus 100.3 μm, P = 0.014). Regression analysis identified eye fatigue (P = 0.026, β=0.122, adjusted for age and sex) and dryness (P =0.024, β=0.130) as significantly correlated with the macular GCC thickness, while the full macular thickness showed no significant correlation. In conclusions, eye fatigue and dryness were positively associated with thickness of the macular GCC. Nonvisual symptoms might therefore play a role in the development of eye fatigue. [ABSTRACT FROM AUTHOR]

Focal choroidal excavation (FCE) is described as an excavated lesion of the choroid that can be detected by optical coherence tomography (OCT). While the exact pathogenesis of FCE remains unclear, it has been proposed in some cases that there is an association with the inflammation in the outer retina. We present a case of FCE development that was detected by spectral domain OCT (SD-OCT) and found to be associated with multiple evanescent white dot syndrome (MEWDS). A 40-year-old Japanese woman was diagnosed with MEWDS based on multiple white dots observed from the posterior pole to the midperiphery, along with yellow granularity in the fovea. SD-OCT revealed separation between the retinal pigment epithelium (RPE) and Bruch's membrane (BM) and discontinuations of the ellipsoid zone, RPE, and BM. At 4 weeks after onset, several of the white dots disappeared, the yellow granularity in the fovea became small, and we detected nonconforming choroidal excavation under the central fovea. The choroidal excavation gradually deepened and changed to a conforming pattern. These findings suggest that the degree of the impairment caused by inflammation and the plasticity of the BM and RPE complex may be associated with different types of acquired FCE. [ABSTRACT FROM AUTHOR]

Purpose: Rhodopsin Pro347Leu transgenic rabbits were previously generated as models of retinitis pigmentosa (RP). While the mechanism underlying the retinal deterioration in these rabbits remains unresolved, it is likely that oxidative stress is one of the factors triggering cellular loss. We have recently succeeded in obtaining a novel activator (RS9) of nuclear factor erythroid 2-related factor (Nrf2, also known as NFE2L2), which regulates antioxidant transcriptional factors. The purpose of this study was to investigate whether RS9 delays progressive retinal degeneration in the transgenic rabbits. Methods: RS9 microspheres (3 mM, 50 µL) were injected into the vitreous of rhodopsin Pro347Leu transgenic rabbits at 6 weeks, after which outer nuclear layer (ONL) thickness was measured by optical coherence tomography. Rabbits were sacrificed at 15 weeks. Results: After intravitreal injection of RS9 microspheres, the concentration of RS9 in the vitreous was maintained at 1 nM for 2 weeks. At a concentration of 0.3 mM and 50 µL, RS9 significantly inhibited thinning of the ONL in transgenic rabbits compared to vehicle-injected transgenic rabbits. In RS9-injected transgenic rabbits, Nrf2-targeted genes had increased significantly, and levels of interleukin-6 mRNA decreased. Conclusions: Activation of Nrf2 signaling has potential as a novel approach for the prevention and treatment of RP, not only by driving intrinsic antioxidant enzymes, but also by inhibiting inflammatory responses. Although microspheres were employed in this study, small implants that release more compounds might be a realistic method for clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: To study the changes in the outer retinal microstructures during a six month period after the onset of acute zonal occult outer retinopathy (AZOOR)-complex by spectral-domain optical coherence tomography (SD-OCT). Methods: Seventeen eyes of 17 patients with the AZOOR-complex were studied. The integrity of the external limiting membrane (ELM), ellipsoid zone (EZ; also called the inner/outer segment junction), and interdigitation zone (IDZ; also called the cone outer segment tips) were evaluated in the SD-OCT images obtained at the initial visit and at six months. The three highly reflective bands were divided into three types; continuous, discontinuous, and absent. The integrity of the outer nuclear layer (ONL) was also assessed. Results: Among the three highly reflective bands, the IDZ was most altered at the initial visit and least recovered at six months. Fifteen of 17 eyes (88%) had a recovery of at least one of the three bands at six months in the retinal area where the ONL was intact, and these areas showed an improvement of visual field. Three eyes (18%) had retinal areas where the ONL was absent at the initial visit, and there was no recovery in both the retinal structures and visual fields in these areas. Conclusions: Our results indicate that more than 85% eyes with AZOOR-complex show some recovery in the microstructures of the outer retina during a six month period if the ONL is intact. We conclude that SD-OCT is a useful method to monitor the changes of the outer retinal microstructure in eyes with the AZOOR-complex. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of melanoma-associated retinopathy (MAR) in a Japanese patient found to have autoantibodies to transient receptor potential cation channel, subfamily M, member 1 (TRPM1). Case: An 82-year-old man presented with blurred vision OS as well as night blindness and photopsia OU. Fundus photography, fluorescein angiography, and spectral domain-optical coherence tomography findings were essentially normal. Goldmann perimetry revealed a relative central scotoma, including the blind spot in the right eye, as well as a relative scotoma around a blind spot OS. The full-field scotopic electroretinograms showed a 'negative-type' pattern OU, suggestive of extensive bipolar cell dysfunction. Systemic examination revealed that the patient had malignant melanoma of the anus with lung metastasis. Autoantibodies to TRPM1 were detected in the serum of the patient by immunoblot analysis. Vitreous opacity developed during follow-up. The visual symptoms and vitreous opacity of the patient were markedly improved after oral prednisolone therapy. The patient died as a result of widespread metastasis of the melanoma at 11 months after his first visit. Conclusion: The present case is the first reported instance of MAR positive for autoantibodies to TRPM1 in an Asian patient. [ABSTRACT FROM AUTHOR]

We report a patient with frosted branch-like appearance retinal vasculitis associated with peripheral capillary nonperfusion and full-field electroretinographic changes. A 62-year-old man presented with sudden bilateral decreased vision accompanied by headaches. His best-corrected visual acuity was 0.01 in both eyes. Fundus examination and fluorescein angiography showed bilateral frosted branch-like appearance retinal vasculitis, and spectral-domain optical coherence tomography showed severe macular edema in both eyes. The cerebrospinal fluid analyses showed an increased lymphocyte count and protein levels. He was treated with systemic corticosteroid therapy, and his best-corrected visual acuity improved to 0.8 OD and 1.0 OS at 6 months after onset. However, fluorescein angiography showed a lack of capillary perfusion in the periphery, and the oscillatory potentials on full-field electroretinography were severely reduced in both eyes. These findings indicated extensive retinal ischemia and inner retinal dysfunction, and that fluorescein angiography and full-field electroretinograms can be useful during follow-up of eyes with frosted branch-like appearance retinal vasculitis. [ABSTRACT FROM AUTHOR]

Long living animal models of retinitis pigmentosa (RP) can provide important information on the retinal changes that occur at the late stages of photoreceptor degeneration. The rhodopsin Pro347Leu transgenic rabbit (P347L Tg) is a model of RP, and it has been used to analyze the functional and morphological changes in the retina following the degeneration of the photoreceptors. They have also been used to test newly-developed therapies to treat eyes with photoreceptor degeneration. However, assessments of the retinal changes in P347L Tg rabbits older than 1-year have not been reported even though the data are important for research on developing new therapies to restore vision at the end stages of RP. The purpose of this study was to determine the time course of the loss of photoreceptor function and the changes in the morphology of the retina of P347L Tg rabbits. The experiments were performed on 26 older P347L Tg rabbits. The results showed that the amplitudes of the ERGs of the P347L Tg rabbits gradually decreased and reached <10 μV between 30- and 54-months-of-age. Histological analysis at these later stages showed a loss of the photoreceptor layer, and OCT analysis showed absence of the layering of the retina. However, the thickness between the inner limiting membrane and the outer plexiform layer was about 1.7 times thicker than the corresponding thickness of WT rabbits in the OCT images. This thickening was caused by a marked gliosis of the entire retina which was confirmed by light and transmission electron microscopy. In addition, immunohistochemical analysis showed there was excessive staining of the glial fibrillary acid protein in the older P347L Tg rabbits although the rod ON bipolar cells and horizontal cells were still present in the inner nuclear layer. Our results indicate that the P347L Tg rabbit progressed to complete photoreceptor loss within 30- and 54-months-of-age and severe gliosis altered the morphology of the retina. • Rhodopsin Pro347Leu transgenic rabbits (P347L Tg) lose photoreceptor function completely by 54-months-of-age. • OCT analysis showed a thickening of inner retina in the P347L Tg rabbits after the loss of photoreceptor function. • The thickening of the inner retina in P347L Tg was caused by significant gliosis in all retinal layers. [ABSTRACT FROM AUTHOR]

: PurposeTo determine the morphology of macular pseudoholes (MPHs) and the relationship of morphology to macular function.: DesignObservational case series.: MethodsOptical coherence tomography (OCT) was performed on 42 eyes of 42 consecutive patients with an epiretinal membrane (ERM) and an MPH. The diameters of the MPH, and the thickness of the foveal and parafoveal retina were measured. Of these 42 eyes, focal macular electroretinograms (FMERGs) were recorded from 22 eyes of 22 patients with a 15 degree stimulus; FMERGs were also recorded with a 5 degree stimulus from 9 eyes of these 22 eyes.: ResultsIn 42 eyes, the mean ± Standard deviation (SD) diameter (437.7 ± 172.8 μm) and geometrical shape of the MPHs were not significantly correlated with the visual acuity. The MPHs were divided into 2 types from the OCT images at the base of MPHs; group A had normal thickness (100–199 μm; n = 29), and group B (n = 13) had thicknesses of ≥ 200 μm, or thickness < 100 μm, or irregular base. The visual acuity in group A (logarithm of the minimum angle of resolution [log MAR] mean ± SD: .083 ± .144) was significantly better than group B (log MAR, .407 ± .212, P < .0001). There was a significant reduction in the amplitude of all components of FMERGs elicited by the 15 degree stimulus in the affected eyes (mean ± SE, A-wave: 1.26 ± .12 μv, B-wave: 3.07 ± .27 μv, oscillatory potentials: 1.23 ± .25 μv) compared with the normal fellow eyes (A-wave: 1.58 ± .13 μv, B-wave: 4.14 ± .27 μv, oscillatory potentials: 2.35 ± .29 μv). A significant correlation was found between the relative amplitudes of the B-wave elicited by the 5 degree stimulus and the visual acuity (r = .918, P = .0005).: ConclusionsIn eyes with an ERM and an MPH, the visual acuity is generally correlated with the OCT images. Macular function of eyes with an MPH resembles eyes with an ERM without an MPH. The effect of the ERM appears to be different on the base and parafovea of the MPHs. [Copyright &y& Elsevier]