The pattern electroretinogram (PERG) after laser treatment of the peripheral or central retina

Purpose. To understand whether laser photocoagulation of the retina for the treatment of diabetic retinopathy (DR) alters directly or indirectly the function of the macular region. Methods. Transient pattern electroretinograms (PERGs) to 30' checks have been recorded in DR patients before and 7-10 days after one treatment session (established protocol with Argon laser) of either the peripheral retina (panretinal treatment) or the centrad retina (paramacular focal treatment). Results. Treatment of the peripheral retina causes, in most eyes, a small increase (about 15% on average) of the PERG amplitude. Focal paramacular treatment causes a marked decrement (about 40% on average) of the PERG amplitude. Simulated retinal amputation induced by focal treatment, obtained by means of adequate stimulus masking, resulted in a 15-20% PERG decrement only. Conclusions. The PERG increase after peripheral treatment may be due to rearrangement of both retinal and choroideal hemodynamics and does not necessarily result in useful long term changes. The PERG decrease after focal, paramacular treatment is far larger than that expected on the basis of the amputated area only. This may result from thermal and/or toxic damaging effects spreading outside the treated area. The results are relevant for both a better monitoring of central retinal function in the course of laser treatment and a better evaluation of the cost/benefit ratio after photocoagulation in DR.