Changes of photopic negative response of multifocal electroretinogram after treatment with Aflibercept in patients with diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes of photopic negative response(PhNR)of multifocal electroretinogram(mf-ERG)in patients with diabetic macular edema(DME)before and after treatment with Aflibercept.METHODS: A total of 37 patients(37 eyes)with DME who visited the Aier Eye Hospital of Wuhan University(Wuhan Aier Eye Hospital)from May 2019 to June 2022, and 0.05 mL of aflibercept was injected per month for consecutive 3mo were included in this retrospective cohort study. Another 20 cases(20 eyes)with normal physical examination to exclude related eye diseases were selected as the control group. The PhNR amplitude of mf-ERG, best-corrected visual acuity(BCVA; LogMAR), central retinal thickness(CRT), capillary plexus in macular area and vessel density(CPVD)of the participants between the two groups were compared before and after treatment.RESULTS: The PhNR amplitude of mf-ERG in DME patients before treatment(201.69±80.92nV)was significantly lower than that in the normal control group(398.87±77.92nV; P<0.01), and the average PhNR amplitude of mf-ERG in DME patients at 6mo after treatment was significantly higher than that before treatment(P=0.036), but it was still significantly lower than the normal control group at 6mo after treatment(P=0.031). In addition, the BCVA(LogMAR)of DME patients increased from 0.64±1.33 to 0.37±1.39(P=0.021)at 6mo after treatment, and CPVD significantly increased compared to that before treatment(P=0.029). Meanwhile, the PhNR amplitude of mf-ERG in DME patients at 6mo after treatment was positively correlated with CPVD at 6mo after treatment(r=0.448, P=0.043), and negatively correlated with BCVA(LogMAR)and CRT(r=-0.647, P=0.011; r=-0.337, P=0.032).CONCLUSION: The PhNR amplitude of mf-ERG in DME patients increased significantly after receiving aflibercept, and it can be used to observe and evaluate the functional changes of retinal ganglion cells in DME patients.

Evaluation of the effects of Hydroxychloroquine on macular central visual function by multifocal electroretinogram / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To use multifocal electroretinogram(MFERG)to evaluate patients' functional changes of the cone system in the macular center of the retina after taking hydroxychloroquine.<p>METHODS:Retrospective study. Totally 264 eyes of 132 patients with rheumatoid arthritis examined in the Ophthalmology Department of the First Medical Center of the PLA General Hospital from January 2017 to November 2019 were included in the analysis. According to the length of medication period, patients were divided into 6 groups: 38 cases 76 eyes in group A did not take hydroxychloroquine, 38 cases 76 eyes in group B took hydroxychloroquine for 1a, 17 cases 34 eyes in group C took hydroxychloroquine for 2a, 18 cases 36 eyes in group D took hydroxychloroquine for 3a, 13 cases 26 eyes in group E took hydroxychloroquine for 5a, and 8 cases 16 eyes in group F took hydroxychloroquine for 5a or more and stopped for 3a. The changes of the best corrected visual acuity(BCVA)and the P1 wave amplitude density value of the first ring retinal response area in the central MFERG were compared among groups.<p>RESULTS:There was no significant difference in BCVA among groups A to F(<i>F</i>=1.287, <i>P</i>=0.270), BCVA in A-F groups were(0.11±0.11, 0.11±0.10, 0.13±0.10, 0.15±0.10, 0.15±0.11, 0.14±0.10 LogMAR),but the amplitude density of P1 wave in group A(122.68±1.87nV/deg2)was significantly higher than other groups(115.76±1.71, 113.38±1.51, 109.10±2.52, 94.61±0.78, 94.02±0.91nV/deg2, all <i>P</i><0.05). <p>CONCLUSION:After long-term administration of hydroxychloroquine, even if the central visual acuity does not change, the results of MFERG examination show that the function of the central cone system of the macular retinal system will decrease with the prolonged administration time, and the visual function cannot recover after stopping taking hydroxychloroquine.

Multifocal electroretinogram manifestation of strabismic amblyopia with eccentric central fixation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the characteristic changes of multifocal electroretinogram(mfERG)in strabismic amblyopia eyes with eccentric fixation.<p>METHODS: A total of 20 patients with strabismus amblyopia and eccentric fixation visited our hospital from January 2018 to December 2020 were collected as the study group(4 patients with exotropia and 16 patients with esotropia), while 20 patients with ametropic amblyopia were collected as the control group. The mfERG was examined under the state of mydriasis, and the amplitude density and incubation period of P1 wave were recorded.<p>RESULTS: Compared with the fellow eyes, the first ring(<i>P</i>=0.001), the second ring(<i>P</i><0.001), the third ring(<i>P</i>=0.001), the fourth ring(<i>P</i>=0.009)and the fifth ring(<i>P</i>=0.026)of strabismus amblyopia eyes were reduced significantly. Compared with the control group, the first ring(<i>P</i>=0.033), the second ring(<i>P</i>=0.002), the third ring(<i>P</i><0.001)and the fourth ring(<i>P</i>=0.014)of strabismus amblyopia eyes were reduced significantly. The incubation period of amblyopia eyes in the strabismus group showed significantly shortened in the first ring(<i>P</i>=0.017)and the second ring(<i>P</i>=0.001)compared with the fellow eyes, and in the second ring(<i>P</i>=0.007)compared with the control group.<p>CONCLUSION: The amplitude density of mfERG P1 wave in strabismic amblyopia eyes with eccentric fixation reduced more with the closer to macular fovea, and reduced more significantly than that in the ametropic amblyopia eyes.

Monitoring methods of chloroquine induced retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Hydroxychloroquine and chloroquine play more and more important roles in the treatment of rheumatism, skin diseases and autoimmune diseases. Irreversible macular diseases,retinopathy and even permanent blindness are common side effects of them. High dose per kilogram of body weight, duration of treatment, presence or absence of keratosis and renal or liver dysfunction are all related to this. Therefore, the examination of the two kinds of drug lesions is also relatively complicated. FAF and SD-OCT are required for wide field examination. For patients with complicated retinopathy, multifocal electroretinogram and the like are also required for diagnosis. The specific examination methods need to be determined by clinical ophthalmologists according to the patient's medication and preliminary examination.

Progress in the application of multifocal electroretinogram in retinal diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Multifocal electroretinogram(mf-ERG)is a common type of electroretinogram. It can objectively, accurately and quantitatively detect the function of each tiny part of the retina, so it is widely used in clinical, especially in retinal diseases. It not only plays an important role in the diagnosis and efficacy evaluation of retinal diseases, but also has an important value in the follow-up and prevention of diseases, even the scope of its application can be extended to basic research. Therefore, this paper reviews the application of multifocal electroretinogram in retinal diseases.

Analysis on the clinical effect and visual acuity prognostic factors of BRVO-ME treated with Ranibizumab / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the functional and structural changes of foveal macula after intravitreal ranibizumab injection in patients with macular edema secondary to branch retinal vein occlusion(BRVO-ME)and screen the factors that can predict the final visual acuity of the patients. <p>METHODS: Prospective, clinical study. In this prospective single-arm study, we observed 25 patients(25 eyes)diagnosed with BRVO-ME who were enrolled from 2018.6-2019.5 in the first central hospital of Baoding. All patients received monthly ranibizumab 0.5mg injections for 3 consecutive months. The best-corrected visual acuity(BCVA),the central macular thickness(CMT)and the vessel perfusion density(VPD), vessel length density(VLD)and fovea avascular zone(FAZ)of superficial capillary plexus(SCP)were evaluated detected by optical coherence tomography(OCT and OCTA)before and 1mo after the third injection. Mf-ERG was used to analyze the amplitude density of P1 wave and latency of P1, N1 wave from ring 1 and ring 2. <p>RESULTS: After treatment, BCVA(LogMAR)was improved significantly compared with that before(0.323±0.086 <i>vs</i> 0.773±0.304, <i>P</i><0.05). CMT was lower than before(239.385±33.175μm <i>vs</i> 489.346±137.453μm, <i>P</i><0.05), but there was no significant change in FAZ, VPD and VLD of SCP within 6mm×6mm of macular area before and after treatment(<i>P</i>>0.05). The latency of P1, N1 wave of ring 1 and ring 2 were significantly decresed from baseline, while the amplitude density of P1 wave was increased(<i>P</i><0.05). Pearson correlation analysis shows that age, baseline BCVA, VLD, VPD, FAZ were significantly correlated with changes in visual acuity before and after treatment(<i>P</i><0.05).<p>CONCLUSION: In patients with BRVO-ME, ranibizumab therapy can reduce CMT, improve BCVA and improve the structure and function of macular area. Age, BCVA before treatment and microstructure parameters of macular area can be used as predictors of vision improvement.

Functional and morphological evaluation of autologous retinal graft in large traumatic macular hole

A 7-year-old boy presented with history of blunt trauma 1 month back. Best corrected visual acuity (BCVA) was 20/200 with optical coherence tomography (OCT) showing a large macular hole. Spontaneous closure of the macular hole seemed unlikely following a month of observation. Pars plana vitrectomy along with autologous retinal graft was performed. At subsequent follow up, hole appeared closed with nasal shrinkage of graft and BCVA improved to 20/100. OCT showed mechanical integration of the graft with adjoining retina. Autologous retinal graft is a feasible option in cases where conventional internal limiting membrane peeling shows lower anatomical success.

Postoperative efficacy and influencing factors of patients with severe proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the efficacy and influencing factors of patients with proliferative diabetic retinopathy(PDR)after vitrectomy.<p>METHODS: Totally 94 patients(112 eyes)with stage VI of PDR in our hospital from January 2015 to January 2018 divided into maculopathy group(<i>n</i>=61 cases, 70 eyes)and non-maculopathy group(<i>n</i>=33 cases, 42 eyes)according to the OCT. The visual acuity, P1 wave amplitude density and retinal reattachment in macular area were compared between the two at 6mo of follow-up. Postoperative efficacy and influencing factors of stage VI of PDR were analyzed by taking vision improvement as a standard of efficacy evaluation.<p>RESULTS: The visual acuity grading in maculopathy group at 6mo after operation was better than that in non-maculopathy group(<i>P</i><0.05). The P1 wave amplitude density in the(1+2)ring in maculopathy group was lower than that in non-maculopathy group(<i>P</i><0.05). Among patients, there were 95 eyes(84.8%)of one-time retinal anatomical reduction, 10 eyes(8.9%)of twice reduction, 2 eyes(1.8%)of 3 times reduction, 1 eye(0.9%)of 4 times reduction and 4 eyes(3.6%)without reduction, and the total reduction rate was 96.4%. The effective rate in patients with maculopathy and patients with long course of diabetes mellitus was lower than that in patients without maculopathy and patients with short course of diabetes mellitus(<i>P</i><0.05), and maculopathy and diabetes duration were independent factors affecting the postoperative efficacy of patients with severe proliferative diabetic retinopathy(<i>P</i><0.05).<p>CONCLUSION: Vitrectomy can improve postoperative visual acuity of patients with stage VI of PDR, and preoperative combination of significant maculopathy and course of diabetes mellitus are important factors affecting postoperative efficacy in patients with severe PDR.

Application of ETDRS chart and mfERG in assessing pathologic myopia combined with macular CNV after treatment / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the efficacy of anti - vascular endothelial growth factor ( VEGF ) and photodynamic therapy ( PDT) on pathological myopia ( PM) combined with choroidal neovascularization ( CNV ) using ETDRS chart and multifocal electroretinogram (mfERG). ·METHODS: Forty-three patients ( 45 eyes) diagnosed by fundus fluorescein angiography ( FFA ), indocyanine green angiograph ( ICGA ) and optical coherence tomography (OCT) with PM combined with macular CNV were recruited in this study. The patients were randomly divided into two groups for different treatments, intravitreal injection with Ranibizumab ( 20 patients, 22 eyes) and PDT (23 patients, 23 eyes). After treatment, all patients had been followed up monthly for 12mo. The further treatments were operated according to referral situations. The best corrected visual acuity ( BCVA) was recorded with the ETDRS chart and mfERG. At the last follow-up, the therapy efficacy was determined by ETDRS numbers and mfERG and analyzed. ·RESULTS: Before treatment, there was no significant difference on the baseline in ETDRS and mfERG latency of N1 wave, latency and the density values of P1 wave between ranibizumab group and PDT group. After 12mo treatment, the ETDRS number in ranibizumab group (39. 23± 20. 06) significantly increased to the baseline by 5. 88±9. 03(P<0. 05), and in PDT group (37. 38±16. 95) was not significantly improved by 0. 33±6. 94(P>0. 05). There was no significant difference in latency of N1 wave, latency and the density values of P1 wave from treatment response of mfERG in the two groups (P>0. 05). · CONCLUSION: In the treatment of macular CNV complicated by the PM, ranibizumab injection can improve visual function better than PDT, while similar on macular.

Analysis on the effect of anti-VEGF drugs on IOP, BCVA and mfERG changes in patients with idiopathic CNV / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of anti - vascular endothelial growth factor ( VEGF) drugs in the treatment of choroidal neovascularization ( CNV ) and its effects on intraocular pressure, best corrected visual acuity ( BCVA) and multifocal electroretinogram ( mfERG) .?METHODS:Totally 44 cases (44 eyes) of idiopathic CNV patients treated in our hospital from February 2015 to January 2017 were selected. All patients were treated with intravitreal injection of anti - VEGF. BCVA, intraocular pressure, mfERG and central retinal thickness ( CRT) were observed after treatment.?RESULTS:At 1 and 3mo after treatment, BCVA and CRT were significantly improved than those before treatment (P<0. 05). At 3mo after treatment BCVA and CRT were 0. 60±0. 15 and 278. 43±40. 10μm, both significantly lower than that in 1mo after treatment (P<0. 05). There was no significant change in intraocular pressure at 1 or 3mo after treatment than before treatment (P>0. 05). At 1 and 3mo after treatment, amplitudes of Ring1, Ring2 and Ring4 NI-P1 were higher than those before treatment (P<0. 05);at 3mo after treatment, the amplitude of Ring3 NI-P1 were higher than those before and 1mo after treatment (P<0. 05);at 1mo after treatment, the amplitude of Ring5 NI- P1 were higher than those before and 3mo after treatment (P<0. 05). The amplitude of Ring6 NI-P1 did not change significantly at 1 and 3mo after treatment, compared with before treatment (P>0. 05).?CONCLUSION: Anti-VEGF drugs are effective in the treatment of idiopathic CNV, which can improve vision and macular retinal function, decrease the retinal thickness, and do not affect the intraocular pressure.

Application of ophthalmic methods in age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

As the increasing population aging,the incidence of age-related macular degeneration is increasing,blinding rate also increasing,so it is very important for the early diagnosis and treatment of age-related macular degeneration.There are many methods to check the aging macular degeneration,such as fundus angiography,optical coherence tomography (OCT),visual field and multifocal electroretinogram (mfERG).In recent years,many emerging ophthalmic methods have emerged and are gradually applied to clinical diagnosis,including optic coherence tomography angiography (OCTA).The function of these methods has its unique advantages,but there are also limitations.This paper will review these existing methods.

Choroidal Thickness Changes Following Vitrectomy in Epiretinal Membrane Based on the Optical Coherence Tomography Pattern

PURPOSE: To analyze the influence of morphological classification in epiretinal membrane (ERM) based on surgical outcomes and optical coherence tomography (OCT) of the postoperative choroidal thickness. METHODS: This observational study included 122 eyes with ERM who underwent vitrectomy. Using OCT, the preoperative ERM was classified into six types: cystoid macular edema (CME), convex, flat, normal foveal contour (Normal), pseudolamellar hole (PLH), and vitreomacular traction (VMT). The preoperative multifocal electroretinogram (mfERG), postoperative change in subfoveal choroidal thickness (SCT), central macular thickness (CMT), and best-corrected visual acuity (BCVA) were compared. RESULTS: Preoperative subfoveal choroidal thickness increased in the VMT type compared to the fellow eye (207 µm vs. 234 µm, p = 0.028). Choroidal thickness decreased in all types at 12 months after vitrectomy (all, P < 0.05). There was a positive linear correlation between the mfERG and the preoperative BCVA (p = 0.001). The initial visual acuity was best in the Normal type followed by the flat, PLH, convex, CME, and VMT types (p = 0.001). The final visual acuity was the best in the Normal type, followed by the PLH, Flat, VMT, Convex, and CME types (p = 0.030). Gas tamponade during the surgery did not affect the surgical outcomes of the CMT (p = 0.458), BCVA (p = 0.550), and SCT (p = 0.127). CONCLUSIONS: Preoperative SCT increased only in the VMT type, but choroidal thickness decreased in all types after vitrectomy, regardless of the preoperative morphology.

Effect of intravitreal injection of anti VEGF drugs on BCVA and mfERG before and after treatment for MCNV and ICNV / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) on best corrected visual acuity (BCVA) and multifocal-electroretinogram (mfERG) before and after treatment for choroidal neovascular disease.METHODS: A total of 264 patients (332 eyes) with macular neovascularization (MCNV) and idiopathic choroidal neovascular disease (ICNV) who underwent pathologic myopia from January 2015 to January 2017 were enrolled in this study.Intraocular pressure and BCVA, fundus using 90D front mirror and slit lamp detection, and the fundus photograph, OCT, ICGA and FFA angiography, mfERG detection were taken.One month after the drug, 1mo after the final treatment, we recorded BCVA, intraocular pressure and mfERG and so on.RESULTS: Ranibizumab was injected into the 254 eyes, and 78 eyes were injected with conbercept.There were 37 eyes injected once, 147 eyes were injected twice, 72 eyes were injected 3 times, 57 eyes were injected 4 times, 19 eyes 5 times.There were no significant differences on intraocular pressure between the two groups (P>0.05).The BCVA before treatment was significantly different compared with those 1mo after treatment and 1mo after the final treatment (P>0.05).The amplitude of Ring1, Ring2 and Ring4 increased after treatment, the difference was statistically significant.(P<0.05).The amplitude of Ring3 and Ring5 increased at 1mo after final treatment(P<0.05).CONCLUSION:Intravitreal injection of anti-VEGF drugs has a significant effect on BCVA and mf ERG in patients with choroidal neovascular disease and is safe.

Multifocal electroretinogram and optical coherence tomography characteristics of macular edema secondary to retinal vein occlusion / 眼科新进展

Objective To investigate the characteristics of multifocal electroretinogram (mf-ERG) and optical coherence tomography (OCT) in macular edema (ME) secondary to retinal vein occlusion (RVO).Methods Mf-ERG and OCT were performed in 38 patients (38 eyes) of ME secondary from RVO patients and 23 normal persons (23 eyes) in the same period of the control group.OCT was used to detect macular retinal thickness (CMT) at foveal area with diameter 1 mm,mf-ERG was used to evaluate the function of macular retina and analyze the amplitude density of P1 wave and latency of P1,N1 wave from ring 1 to ring 5.Results Compared with the control group,the amplitude densities of P1 in BRVO group were obviously decreased in ring 2 (35.95 ± 17.04)nV · deg-2,ring 3(24.72 ±8.32)nV · deg-2,ring 4(19.28 ±6.38)nV ·deg-2,ring 5 (13.49-± 6.16) nV · deg-2,respectively (all P ＜ 0.05);The latencies of P1 were prolonged significantly in ring 2 (35.74-± 3.72) ms (P ＜ 0.05);The latencies of N1 were prolonged significantly in ring 2 (18.43-± 4.63) ms,ring 3 (18.67-± 2.86) ms (both P ＜ 0.05).Compared with the control group,the amplitude densities of P1 in CRVO group were obviously decreased in ring 1 (81.58 ± 43.15) nV · deg-2,ring 2 (33.71 ±9.81) nV · deg-2,ring 3 (22.15 ± 9.75) nV · deg-2,ring 4 (16.65-± 6.38) nV · deg-2,ring 5 (14.18-± 4.59) nV · deg-2,respectively (all P ＜ 0.05);The latencies of P1 were prolonged significantly in ring 2 (37.56 ± 5.55) ms,ring 3 (37.31 ± 5.22) ms,ring 4 (35.71 ±5.63) ms,ring 5 (37.30 ± 5.37) ms (all P ＜ 0.05);The latencies of N1 were prolonged significantly in ring 1 (21.82 ±5.76) ms,ring 2(19.18 ±4.82) ms,ring3 (19.31 ±4.25)ms,ring 4 (19.05 ± 4.55) ms,ring 5 (19.43 ± 4.12) ms (all P ＜ 0.05).There was negative correlation between CMT and amplitude densities of P1 of ring 1 in CRVO group (r =-0.576,P ＜ 0.05).Conclusion OCT combined with mf-ERG can comprehensively reflect the change of retinal fumction and structure in ME secondary to RVO.

Characteristics of multifocal electroretinogram in patients with Parkinson′s disease / 中华神经科杂志

Objective To investigate the changes of multifocal electroretinogram ( mf-ERG ) in patients with Parkinson′s disease.Methods Forty-five Parkinson′s disease patients ( 70 eyes ) and 35 normal controls (60 eyes) enrolled in the Second Affiliated Hospital of Soochow University from February 2015 to February 2016 received mf-ERG examination and general ophthalmology examinations including best corrected vision acuity, slit-lamp test, fundus examination, intraocular pressure and vision field test. Results The amplitude density of P 1 wave in Parkinson′s disease patients was dramatically decreased in ring 1, ring 2 and ring 5 compared with the normal controls (amplitude density of P1 in ring 1:(100.58 ± 41.19) nV/deg2 vs (138.10 ±17.16) nV/deg2,t=5.086,P<0.01; amplitude density of P1 in ring 2:(21.93 ±7.46) nV/deg2 vs (37.56 ±9.39) nV/deg2, t=9.844, P<0.01; amplitude density of P1 in ring 5:(7.07 ±3.04) nV/deg2 vs (10.22 ±3.68) nV/deg2 ,t=4.924, P<0.01).The latency of P1 wave in ring 1, ring 3 in Parkinson′s disease patients was significantly higher than the control group (latency of P1 wave in ring 1:(42.72 ±8.09) ms vs (37.90 ±5.95) ms, t=-3.155, P<0.01;latency of P1 wave in ring 3:(41.20 ±7.63) ms vs (37.80 ±4.59) ms, t=-2.995, P<0.01).The implicit time of N1 wave in ring 1 in Parkinson′s disease patients was delayed , which had statistically significant difference compared with the normal controls ((21.92 ±7.87) ms vs (19.04 ±4.19) ms, t=-2.012, P=0.046).However, in the amplitude of N1 wave, there was no statistically significant difference between the two groups . Conclusions The vision function has already decreased in Parkinson′s disease patients , even before the vision acuity is normal .The mf-ERG test can find the changes of vision function in Parkinson′s disease patients, which are the decrease of amplitude density of P 1 , the latency of implicit times of P 1 wave and N1 wave in some regions of the retina .

Quantitive study for retinal function before and after photocoagulation in patients with diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the retinal function in patients with diabetic macular edema after photocoagulation. <p>METHODS: A total of 30 eyes in 19 patients with diabetic macular edema(DME), who were diagnosed through fundus fluorescein angiography, consecutively recruited from March 2010 to March 2014 and were treated with macular grid pattern photocoagulation. Multifocal electroretinogram(mfERG)system(version 3.15)was performed before and after photocoagulation therapy for 3mo. All data were statistically analyzed. <p>RESULTS: The amplitude densities of a-ware and b-ware for the fovea increased after macular grid pattern photocoagulation therapy, and there were significantly changes relative to its preoperation(<i>t</i>=-3.7683, <i>P</i><0.01; <i>t</i>=-3.6570, <i>P</i><0.01). No remarkable changes in the latency of a-ware and b-ware of fovea were measured before and after photocoagulation(<i>t</i>=1.7103, <i>P</i>>0.05; <i>t</i>=1.5623, <i>P</i>>0.05 ). Compared with pretreatment, the amplitude densities of a-ware and b-ware at macular were statistically larger(<i>t</i>=4.8337, <i>P</i><0.01; <i>t</i>=-2.0376, <i>P</i><0.05). The latency of a-wave and b-wave at macular was significant longer after treatment(<i>t</i>=-2.1892, <i>P</i><0.05; <i>t</i>=-3.5024, <i>P</i><0.01). There were no significant differences in the amplitude densities of a-ware and b-ware at paramacular after therapy(<i>t</i>=-1.4387, <i>P</i>>0.05; <i>t</i>=-0.1766, <i>P</i>>0.05). It was significant longer in the latency of a-wave and b-wave at paramacular after photocoagulation(<i>t</i>=-2.0905, <i>P</i><0.05; <i>t</i>=-2.5646, <i>P</i><0.05). <p>CONCLUSION: The laser photocoagulation treatment for DME can improve the retinal function at fovea, which benefits the vision acuity. Unfortunately,it induces extensively damaging effects on the macula and paramacular.

Changes of multifocal electroretinogram in subclinical diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the changes of first order kernel ( FOK ) and second order kernel ( SOK ) of multifocal electroretinogram( mf-ERG) in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy. ·METHODS: Totally 32 patients ( 58 eyes ) with type 2 diabetes mellitus ( DM ) without apparent diabetic retinopathy( DR) were detected by mf-ERG, from June 2014 to May 2015. Thirty cases ( 60 eyes ) of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups. ·RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased (t=3. 099, P=0. 012). The SOK b-wave latency in diabetes group was statistically delayed (t=2. 643, P=0. 025), and the SOK b-wave amplitude statistically decreased (t=4. 833, P<0. 01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus. ·CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

A Case of Acute Macular Neuroretinopathy in a Young Male

PURPOSE: We report a rare case of unilateral acute macular neuroretinoapthy in a young male. CASE SUMMARY: A 35-year-old male presented with a 2-day history of paracentral scotoma. He had suffered for 2 days from a flu-like illness, and his best corrected visual acuity was 20/20 OD and 20/20 OS. Pupillary reflex was normal and no relative afferent pupillary defects were not found. Ocular movement test was normal and pain on ocular movement was not noticed. Ophthalmoscopic examination of the left eye revealed multiple exudates lining the nasal macula toward the fovea. A Humphrey visual field study identified small paracentral scotoma. Spectral domain optical coherence tomography (SD-OCT, Heidelberg Engineering, Heidelberg, Germany) of the lesions showed a hyper-reflective lesion located in the outer plexiform layer and inflammatory cell infiltration. Fluorescent angiography was normal in the macula but showed late leak at the disc. The multifocal electroretinogram (mfERG) showed decreased foveal P1 amplitude in the left eye. The patient was diagnosed with acute macular neuroretinopathy and was treated with 60 mg of prednisolone. His subjective symptoms were improved, the paracentral scotoma disappeared, and the lesions appeared different upon SD-OCT; specifically, the hyper-reflective lesion disappeared and the outer plexiform layer showed thinning. CONCLUSIONS: Acute macular neuroretinopathy is a rare disease, and we report a case using SD-OCT and mfERG.

Obtención, interpretación y usos del electrorretinograma multifocal / Obtaining, interpreting and using the multifocal electroretinogram

Las pruebas electrofisiológicas oculares constituyen un variado grupo de herramientas diagnósticas de extremada relevancia, sobre todo por su objetividad. El electrorretinograma multifocal se encuentra entre los más novedosos y promisorios de este selecto grupo y, a la vez, entre las de mayor complejidad de obtención. Se realiza una revisión bibliográfica de los aspectos relacionados con la obtención, representación y aplicaciones clínicas del electrorretinograma multifocal(AU)

The ocular electrophysiological tests are a varied group of extremely relevant diagnostic tools that stand out because of their objectivity. The multifocal electroretinogram is among the most novel and promising in this selected group, but at the same time, it is one of the most complex to be obtained. A literature review of the aspects related to obtaining, representation and clinical applications of the multifocal electroretinogram was made and presented in this paper(AU)

Significance of visual electrophysiological techniques in the early diagnosis of glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

Glaucoma is a group of diseases which can threaten and damage the optic nerve and its visual pathway, leading to visual impairment as a result. Glaucomatous optic neuropathy is a chronic disease accompanied by apoptosis of retinal ganglion cells ( RGCs ) , visual field defect and cupping of optic nerve head. The gold standard in functional glaucoma evaluation is standard automated perimetry ( SAP) , but it is often limited to the subjective feelings of the patients. Still, visual electrophysiological techniques cannot replace the conventional inspection, but with its rapid development, it has provided a new strategy for the early diagnosis of glaucoma as a supplement because it can show changes in amplitude and latency before visual field defect. Here we review three special electroretinograms and multifocal focal visually evoked potentials in the early diagnosis of glaucoma.