Figure 2.

Representative spectral-domain optical coherence tomography and multi-focal electroretinogram changes of a 53-year-old female patient preoperative minimum and base diameters were 734 μm and 965 μm, respectively; defects of the external limiting membrane and the ellipsoid zone were indicated by arrow heads and arrows, respectively. Cystoid edema and elevation of the margin were demonstrated (a). On three-dimensional plot of multi-focal electroretinogram, the foveal and perifoveal area showed two separate small “peaks” (d), which reflected marked depression of the macular area and poor fixation due to low central vision. The response density of the central seven hexagons in this patient (g, the black numbers within the red hexagon) were much lower than a normal subject (g, the blue numbers). The initial best corrected visual acuity was 0.04 (20/500). One month after surgery, the macular hole closed, with partial restoration of both the external limiting membrane and the ellipsoid zone (b). The corresponding multi-focal electroretinogram showed a confluent blunt single peak (e), and the average retinal response density of the central seven hexagons and the fovea had increased from preoperative 8.5 and 8.8 nV/deg² to 9.5 and 12.3 nV/deg², respectively (h). The best corrected visual acuity was 0.13 (20/160) at this visit. Three months postoperatively, a further inward reconstruction of the external limiting membrane and the ellipsoid zone were observed (c). On three-dimensional plot of multi-focal electroretinogram, the peak became more sharp, with higher elevated immediate surrounding area (f); the corresponding average retinal response density of the central seven hexagons and the fovea had increased to 11.1 and 12.5 nV/deg², respectively (i). The 3-month postoperative best corrected visual acuity was 0.20 (20/100).