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@#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.
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AIM: To investigate autofluorescence (AF) images of classical retinitis pigmentosa (RP) at advanced stage correlated with central vision. METHODS: Thirty-seven patients (70 eyes) with classical RP at advanced stage were observed. AF imaging was performed using a Heidelberg Retina Angiograph 2 ( HRA-2) scanning laser system with the field 30°, the pixels 1 536×1 536 and pupil diameters >6mm. Some patients underwent automated static peri-metry and the flash electroretinogram(FERG) were performed according to International Society for Clinical Electrophysiology of Vision( ISCEV) standard. RESULTS: All patients were classified as four patterns according to their manifestation of AF they were intact, patchy, solitary island and central hypofluorescence patterns. Different pattern showed different central vision. The data demonstrate high correlation between the central cone function and AF changes of the fundus. There is significant correlation (n= 57, r= 0.385,P＜0.01) between central vision and the AF area and between age and AF area (n= 57, r= -2.67,P＜0.05).CONCLUSION: AF images is valuable to the monitoring of central cone function and in predicting retention of central vision. The changes of AF images correlated with central vision and different pattern showed different vision.
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The natural course of visual acuity of choroidal neovascularization (CNV) membrane is known to be poor.When fovea is involved, only a subset of patients is eligible for laser photocoagulation or alternative treatment odalities.Radiation therapy has been investigated for applying to such cases, however there have been controversies among reports on the effec-tiveness of radiation therapy.Hence we intended to evaluate the effective-ness of radiation therapy quantitatively.Twenty-one eyes with subfoveal CNV were treated with 4 MV X-ray (total dose of 20 Gy).After the follow-up period of 6months or longer, the visual acuity remained stable or improved from the initial visual acuity in 15 of 21 eyes (71.4%). Based on indocyanine green (ICG)video angiography, the CNVs decreased in their size in 16 of 21 eyes (76.2%)and this difference was statistically significant. These results suggest that radiation can induce regression of subfoveal CNV and maintain central vision in a significant number of patients and we believe that larger, longer study is necessary.