Early multifocal electroretinography findings after intravitreal Conbercept in the treatment of wet age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the early changes of retinal function in patients with wet age-related macular degeneration(ARMD)after intravitreal Conbercept treatment by multifocal electroretinography(mfERG). <p>METHODS: Wet ARMD patients diagnosed by fundus fluorescein angiography and received intravitreal injection of Conbercept(0.05mL/0.5mg)were included. Best corrected visual acuity(BCVA), incubation of N1, P1 and amplitude of P1 in mfERG test were recorded before and 1mo after treatment. <p>RESULTS: Twenty patients(20 eyes)were enrolled in total. The mean BCVA was 0.80±0.48 LogMAR at baseline and improved to 0.65±0.50 LogMAR after treatment(<i>P</i><0.001). Mean P1 amplitude density of the mfERG Ring 1 increased from 39.59±16.60nV/deg² to 53.81±20.41nV/deg²(<i>P</i>=0.006). The change in visual acuity was positively correlated with the change in P1 amplitude density of Ring 1(<i>r</i>=-0.776, <i>P</i><0.001). <p>CONCLUSION: Intravitreal conbercept injection can improve the central retinal function of wet ARMD patients in the short term.

Outcomes of 25-gauge vitrectomy with air tamponade for idiopathic macular hole repair surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole (IMH).METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study.All patients underwent 25-gauge pars plana vitrectomy (PPV) combined with phacoemulsification and air tamponade.Best corrected visual acuity (BCVA, logMAR), perimetry and multifocal electroretinography (mfERG) were conducted before and after the operation.Anatomical changes were evaluated with optical coherence tomography (OCT).RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy.The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively (P<0.001).In the visual field of central 10°, the average mean deviation (MD) decreased from-3.59±1.83 dB preoperatively to-2.51±1.36 dB postoperatively (P<0.001) and the average pattern standard deviation (PSD) decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively (P=0.001).The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly (P<0.05).The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA (P<0.001, P=0.001, respectively).CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.

Change of optical coherence tomography and multifocal electroretinography in myopia patients / 国际眼科杂志(Guoji Yanke Zazhi)

Myopia is the highest incidence of eye disease in society, it threated people`s eye health seriously.At present, many researchers measure the structural changes of retina which caused by the extension of eye axial due to the refractive error according to the optical coherence tomography(OCT).Besides, multifocal electroretinography(mf-ERG) was used to detect the function of retina in myopia.Global flash mf-ERG can evaluate the function of retina including both outer and inner retina.Some researchers focus on the correlation between structural and functional changes in myopia using OCT and mf-ERG.More researches are needed to clarify the structural and functional changes in myopia.

Efficacy of intravitreal injection with Ranibizumab combined with laser photocoagulation for macular edema secondary to macular branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the efficacy of intravitreal injection with ranibizumab combined with laser photocoagulation for macular edema ( ME ) secondary to macular branch retinal vein occlusion( MBRVO) . METHODS:A retrospective analysis included 33 patients (33 eyes) with ME secondary to MBRVO were taken. All patients received intravitreal injection of 0. 5mg ranibizumab ( 0. 05ml ) at first visit. The continue PRN treatment and laser photocoagulation were based on the visual acuity changes and optical coherence tomography findings. The changes of best corrected visual acuity ( BCVA) , central macular thickness( CMT) , and amplitude density and latency of P1 wave in mfERG were observed before treatment and 6mo after treatment. RESULTS: Before the treatment, logMAR was 0. 68±0.35, 6mo after treatment was 0. 34±0. 23, BCVA was improved obviously ( P CONCLUSION: Intravitreal injection with ranibizumab combined with laser photocoagulation for ME secondary to MBRVO can reduce the CMT and improve visual function.

Clinical Usefulness of Binocular Multifocal Electroretinography in Patients with Monocular Macular Disease

PURPOSE: To evaluate the clinical usefulness of binocular multifocal electroretinography (mfERG) by comparing results with conventional monocular mfERG in patients with monocular macular disease. METHODS: mfERG testing was conducted on 32 patients with monocular macular disease and 30 normal subjects. An initial mfERG was simultaneously recorded from both eyes with two recording electrodes under binocular stimulation. A second mfERG was subsequently recorded with conventional monocular stimulation. Amplitudes and implicit times of each ring response of the binocular and monocular recordings were compared. Ring ratios of the binocular and monocular recording were also compared. RESULTS: In the macular disease group, there were no statistical differences in amplitude or implicit time for each of the five concentric rings between the monocular and binocular recordings. However, with binocular simulation, the ring ratios (ring 1 / ring 4, ring 1 / ring 5) were significantly reduced in the affected eye. In the normal control group, there were no statistical differences in any parameters between the monocular and binocular recordings. CONCLUSIONS: Binocular mfERG could be a good alternative to the conventional monocular test. In addition, given that the test needs stable fixation of the affected eye during the binocular test, the reliability of the test results could be improved, especially for patients with monocular macular disease.

A Case of Bilateral Acute Macular Neuroretinopathy after URI

PURPOSE: To report a case of bilateral acute macular neuroretinopathy (AMN) following flu-like illness. CASE SUMMARY: A 42-year-old woman complained of paracentral scotoma in both eyes 2 weeks after an episode of flu. Fundus examination showed several dark, brown-reddish, wedge-shaped lesions in both maculae, and red-free fundus photography confirmed the lesions. Fluorescein and indocyanine green angiography was normal. Amsler grid test demonstrated paracentral scotoma. The multifocal electroretinogram (ERG) response was subnormal, and ocular coherence tomography (OCT) confirmed an impaired photoreceptor layer in both eyes. Under the diagnosis of AMN, the patient was followed-up without treatment. No subjective changes were observed during follow-up, although the damage to the photoreceptor was partially recovered based on spectral-domain OCT (SD-OCT). CONCLUSIONS: Multifocal ERG and SD-OCT may be helpful to diagnose AMN. Despite partial recovery of clinical signs on SD-OCT, paracentral scotoma could be sustained for a long period of time.

A Case Report of Acute Zonal Occult Outer Retinopathy Showing Acute Idiopathic Blind Spot Enlargement

PURPOSE: To present a case of acute zonal occult outer retinopathy (AZOOR) with acute idiopathic blind spot enlargement (AIBSE) investigated using indocyanine green angiography (ICGA), multifocal electroretinography (multifocal ERG) and spectral domain-OCT (SD-OCT). CASE SUMMARY: A healthy 31-year-old female with photopsia and a five-day visual field defect in her left eye showed no abnormal findings in ocular examinations such as slit lamp and fundus examination, fluorescein angiography (FAG), or full field ERG as well as in the systemic neurologic examination. In the late phase of ICGA, there were multiple hypofluorescent spots around the optic disc and scattered through the posterior pole. The patient showed an amplitude decrease of multifocal ERG and the destruction of the boundary between the inner and outer segments of the photoreceptors in the SD-OCT examined in the retinal area corresponding to the visual field defect. The patient was diagnosed with AZOOR and was followed-up without treatment. After three months, no abnormal SD-OCT or visual field test findings were observed and no symptoms remained; however, a slightly depressed response on multifocal ERG was present. CONCLUSIONS: ICGA, multifocal ERG and SD-OCT could be useful methods to detect AZOOR with EBS.

Correlation Between Multifocal Electroretinography and Visual Acuity After Resolution of Diabetic Macular Edema

PURPOSE: To evaluate the prognostic value of multifocal electroretinography (mfERG) after a decrease of retinal thickness in eyes with diabetic macular edema (DME). METHODS: Sixty patients (60 eyes) underwent intravitreal injection of triamcinolone acetonide or bevacizumab for diabetic macular edema. Eyes were divided into three groups, according to foveal thickness : Group A (==800 micrometer, n=20 eyes). Best-corrected visual acuity (BCVA) and mfERG responses from the most central seven hexagons were analyzed both before and after treatment. RESULTS: The pre-injection P1 amplitudes of mfERG correlated significantly with end-point BCVA in Groups A and B (p0.05) in Group C. CONCLUSIONS: The level of P1 amplitudes of mfERG may be a useful tool to predict visual outcomes after a decrease of retinal thickness in patients with diabetic macular edema.

Clinical Features of Ocular Disabilities

PURPOSE: To describe the characteristics of the disabled patients visiting the eye clinic in our institute. METHODS: We carried out a retrospective analysis of 35 cases in our clinic from April 2004 to June 2008 using the McBride disability evaluation. We investigated the clinical features and the causes of disorders through visual acuity, visual field and ocular motility. RESULTS: Thirty-three (94.3%) of the 35 patients had disabilities due to trauma; twelve (34.3%) of them were caused by traffic accidents, and 21 (60%) of them were due to blows or lacerations. Other causes of disability were glaucoma and retinal break (5.8%). Nine patients (25.7%) had abnormal findings in the visual field examination, and nine other patients (25.7%) had limitations in ocular motility. Twenty-eight patients (80%) had decreased visual acuity, and nine (25.7%) had multiple symptoms. CONCLUSIONS: Considering the contribution of disability estimation of visual field and ocular motility in McBride disability evaluations, we considered the importance of repetitive examinations and evaluations. When patients complained of unexplained decreased visual acuity with no anatomical abnormalities, multifocal ERG and multifocal VEP should be considered in order to distinguish it from malingering or functional visual loss.

Findings from multifocal electroretinography of posterior uveitis in Behcet's disease / 眼科研究

Background Behcet's disease is a refractory panuveitis with high blindness rate.Multifocal electroretinography (mfERG) is a useful tool for the evaluation of the function of the posterior retina.ObjectiveThe aim of this study is to assess the characteristics of Behcet's disease using the mfERG.Methods mfERG was recorded in 68 eyes of 39 cases with active stage of Behcet's disease.All of the patients were diagnosed based on the Standard of International Study Group for Behcet's Disease and assigned to the cystoid macular edema (CME) group and the diffuse macular edema (DME) group after assessment by fundus fluorescein angiography (FFA).Seventeen normal subjects were used as controls.Oral informed consent was obtained from all of the subjects prior to this trial.mfERG recording followed the ISCEV Guidelines for Clinical Multifocal Electroretinography (2007 edition).The response density and latency of P1 and N1 waves in 6 rings were analyzed and compared.Results The amplitudes of N_1 waves from rings 1 through 6 and N1 wave from rings 1 through 5 were significantly declined in patients with Behcet's disease compared with normal control (P＜0.01).All of the latencies of P_1 waves from rings 1 through 6 were insignificantly shortened in patients with Behcet's disease compared with normal control (P＞0.05).The amplitudes of P_1 and N_1 waves from rings 1 through 6 in diffuse macular edema group were considerably lower than those in the cystoid macular edema group (P＜0.05,P＜0.01).A test of visual acuity showed a negative correlation to the amplitude and latency of N_1 wave (r=-0.36,-0.37,P＜0.05 ) and a positive correlation with the amplitude of N1 wave (r=0.43,P＜0.05) in the DME group.In the CME group,a test of visual acuity presented a negative correlation to the amplitude and latency of N1 wave and latency of P1 (r=-0.41,-0.35,-0.40,P＜0.05 ) and a positive correlation with the amplitude of P1 wave (r=0.48,P＜0.05).Conclusion mfEGR demonstrates that retinal electro-activity is abnormal in eyes with Behcet's disease.The distinct functional disorder is situated around the fovea.

Investigação eletrofisiológica multifocal de sujeitos com toxoplasmose ocular / Multifocal eletctrophysiological investigation of subjects with ocular toxoplasmosis

Objetivo: avaliar as amplitudes das respostas eletrorretinográficas multifocais de pacientes com perda visual decorrentes de toxoplasmose ocular. Método: estudo longitudinal prospectivo comparativa no qual foi usado o sistema VERIS Science v6.0.5d para estimulação, registro e extração da resposta para cada hexágono que constitui o estímulo em 3 sujeitos com toxoplasmose ocular (grupo estudo) e 10 sujeitos saudáveis (grupo controle). Os dados dos registros foram exportados para análise no ambiente de programação MATLAB. Neste ambiente de programação foi realizada a análise dos componentes principais sobre as respostas multifocais para aumentar a razão sinal-ruído dos registros. A amplitude do registro dos pacientes foi comparada com os resultados do grupo controle. Foi realizada a avaliação psicofísica do campo visual em todos os indivíduos através da perimetria estática de Humphrey. Resultados: os registros de todos os sujeitos saudáveis exibiram três deflexões como descritos internacionalmente. Nos pacientes com toxoplasmose ocular os resultados da amplitude de resposta apresentaram semelhanças dos obtidos com a perimetria visual. Conclusão: a eletrorretinografia multifocal permite quantificar as perdas de sensibilidade retiniana em pacientes com toxoplasmose ocular de uma forma que pode ser diretamente comparável à avaliação psicofísica do campo visual.

Purpose: to perform a quantitative analysis of the visual losses of three patients suffering from ocular toxoplasmosis by using multifocal electroretinography. Methods: a VERIS Science v6.0.5d hardware and software was used to evoke retinal bioelectric activity, to record this activity, and to extract its first order kernel. Data were exported to MATLAB environment to perform a principal component analysis of the first order kernel. Multifocal eletroretinography obtained from patients were then compared with those obtained from healthy subjects. We performed psychophysical assessment of visual in all subjects through the static Humphrey perimetry Results: recordings from healthy subjects exhibited three components. Ocular toxoplasmosis patients had decreased response amplitude in many areas of the retina and the pattern of visual loss is similar to that found by threshold static automated perimetry. Conclusion: patients with ocular toxoplasmosis showed different degrees of visual impairment that were revealed by using multifocal electrorretinography. The electrophysiological losses matched those revealed by threshold static automated perimetry.

Multifocal Electroretinography in Retinitis Pigmentosa With Non-recordable Full-field Electroretinography

PURPOSE: To investigate the clinical potential of multifocal electroretinography (mf-ERG) for the evaluation of residual retinal function in retinitis pigmentosa (RP). METHODS: From a group of 41 patients with RP examined for full-field and mf-ERGs, 24 patients were selected in whom the full-field ERGs were non-detectable. Data from the mf-ERGs of this group were reviewed retrospectively. Patients were divided into two groups based on best corrected visual acuity (BCVA); Group A, with a BCVA of less than 0.5, and group B with a BCVA greater than 0.5. The amplitudes and implicit times of Ring 1 and Ring 2 among six concentric rings were measured for comparison between mf-ERG groups. RESULTS: In the mf-ERGs, the amplitudes of Ring 1 and Ring 2 were reduced and implicit time was delayed in all 48 eyes of 24 patients in whom scotopic and photopic responses were non-detectable in full-field ERGs, whereas, there were no detectable responses in Rings 3 thru 6. There was a greater reduction in amplitude and an increased delay in implicit time in group A. CONCLUSIONS: The mf-ERG can estimate the residual macular function in a group of patients with RP in whom the full-field ERG is non-recordable.

Multifocal Electroretinography After Reattachment of Macula-Off Retinal Detachment

PURPOSE: To assess macular function by multifocal electroretinography after reattachment of macula-off retinal detachment and to evaluate relationship between duration of macular detachment (DMD) and functional recovery. METHODS: Nineteen patients (19 eyes) with macula-off rhegmatogenous retinal detachment underwent pneumatic retinopexy or scleral buckling. Retinal reattachment was obtained successfully in all patients. Duration of follow-up of all patients is at least more than 12 months. Eyes were divided into 2 groups, corresponding to the DMD : Group A (within 7 days, n=9 eyes), Group B (>7 days, n=10 eyes). The amplitudes and implicit times of N1-wave and P1-wave of mfERGs in Area 1 (Ring 1), Area 2 (Ring 1+2) were compared between Group A and B and between Group A and control group. RESULTS: The P1 amplitudes in Area 1 and 2 were significantly different between Group A and B (P0.05). There were no significant difference of all data between Group A and control in Area 1 and 2 (P>0.05) The implicit times of N1, P1 were not significantly different between Group A and B. CONCLUSIONS: The DMD plays a key role in recovery of visual function after reattachment. The mfERG is a useful tool to evaluate the recovery of macular function after reattachment of macula-off retinal detachments.

Optical Coherence Tomography and Multifocal Electroretinography in a Patient with Choroidal Osteoma

PURPOSE: We present a case of choroidal osteoma and report a pattern of optical coherence tomography and multifocal electroretinography with a literature review. CASE SUMMARY: Using B-scan and CT, we performed OCT and MF-ERG in a patient diagnosed with choroidal osteoma. OCT revealed serous retinal detachment in the macula and a thick, irregular plate-like structure with high reflectivity in the choroidal mass lesion. MF-ERG demonstrated that Trace arrays show suppression of central and peripheral signals, especially in central lesions. Ring averages show reduced amplitudes in all locations, and 3D-topography of the response density shows marked suppression of the central signal and no foveal peak in comparison with the unaffected left eye. CONCLUSIONS: In patients with choroidal osteoma, OCT can reveal thick plate-like high reflectivity with an irregular outer surface, and MF-ERG can predict retinal dysfunction.