ABSTRACT
Flicker-ERG (FERG) amplitude and glial indices Cg were measured to estimate angiotensin- converting enzyme (ACE) inhibitor Perindopril effect on retinal glial-neuronal interactions in patients with type II diabetes and diabetic retinopathy (DR). Intake of 5 mg Perindopril daily during 2 months improved photoreceptor and bipolar cells function in all stages of DR with the most significant effect in preproliferative DR (PPDR). After treatment course initially supernormal FERG scotopic glial indices reduced by 8,3-12 Hz (25-33%) in nonproliferative DR and PPDR and by 10% in proliferative DR. In photopic conditions moderate decrease of index was revealed in FERG by 30Hz only in PPDR. Obtained results show Perindopril to cause significant improvement of retinal glial-neuronal interactions in dark adaptation and poor positive dynamics in photopic conditions.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis , Electroretinography/methods , Neuroglia/pathology , Perindopril/therapeutic use , Retinal Neurons/pathology , Administration, Oral , Adult , Aged , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Dark Adaptation/physiology , Diabetes Mellitus, Type 2/drug therapy , Diabetic Retinopathy/etiology , Diabetic Retinopathy/physiopathology , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neuroglia/drug effects , Perindopril/administration & dosage , Retinal Neurons/drug effects , Treatment OutcomeABSTRACT
The pathophysiological mechanisms responsible for the development of choroidal neovascularization (CNV) in age-related macular degeneration (ARMD) still remain to be little studied and clinical electrophysiology that has a wide spectrum of objective studies plays a great role in the assessment of regularities of retinal functional changes in this disease. Recording of different types of electroretinograms (ERG) from the ISCEV standards and multifocal ERG is most extensively used to characterize CNV. The review considers the pattern of ERG changes in normal physiological aging and the specific features of suppressed retinal electrogenesis in neovascular ARMD. The diagnostic capacities of different electroretinographic methods, their disadvantages and limits in the evaluation of retinal functions in patients with CNV are compared.
Subject(s)
Choroidal Neovascularization/diagnosis , Electroretinography/methods , Macular Degeneration/diagnosis , Monitoring, Physiologic/methods , Retina/physiopathology , Choroidal Neovascularization/etiology , Choroidal Neovascularization/physiopathology , Diagnosis, Differential , Humans , Macular Degeneration/complications , Macular Degeneration/physiopathology , Reproducibility of ResultsABSTRACT
Electroretinography is an informative tool in evaluating retinal function in age-related macular degeneration (ARMD) and in monitoring the treatment of choroidal neovascularization (CNV). The review gives the results of electroretinographic studies in the monitoring of CNV, by using photodynamic therapy (PDT) and angiostatic agents and in combined PDT and anti-VEGF therapy. The regularities of retinal functional changes in the early and late periods after mono- and combined therapy are considered. The informative value of various electroretinographic studies was compared in the evaluation of retinal functional changes after therapy and in the prediction of its efficiency. Multifocal electroretinography is today of the greatest value among other conventional methods; however, there is a need for searching for new objective indicators that enable assessment of progress in the treatment of neovascular ARMD and optimization of indications for this or that treatment, particularly when new and expensive technologies of treating CNV emerge.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Choroidal Neovascularization , Electroretinography/methods , Macular Degeneration , Monitoring, Physiologic/methods , Photochemotherapy/methods , Retina/physiopathology , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/drug therapy , Choroidal Neovascularization/etiology , Diagnosis, Differential , Humans , Macular Degeneration/complications , Macular Degeneration/diagnosis , Macular Degeneration/drug therapy , PrognosisABSTRACT
The investigation studied the topographic features of retinal electrogenesis in regmatogenic retinal detachment (RRD) in the myopic eye, by using multifocal electroretinography (mfERG). Both eyes from 12 patients were used to analyze the amplitude and latency of the first negative and positive mfERG first-order kernel components averaged over the entire stimulation area, by rings, quadrants of vision fields and in the areas of the adjacent and detached retina. The myopic eye in RRD even without macular involvement showed a selective reduction in R1 amplitude when central retinal rings 1 and 2 were stimulated, which suggests that the macular region is highly sensitive to the impaired anatomic integrity of the adjoining retinal zones. Longer latency of mfERG N1 is most typical of the stimulation of the retinal macular region in recent RRD, and that is characteristic of the near and middle retinal periphery in a 1-2-month history of RRD, which may be indicative of the progression of impairments in the rod system. The reduction in P1 amplitude is most pronounced in a 1-2-month history of RRD. The findings suggest that a 1-month history is critical in the development of specific functional changes in the detached retina and mainly in its mid-periphery and support a need for early (less than 4-week) surgical treatment for retinal detachment particularly in the eyes of patients with myopic changes in the eye grounds. The authors show it advisable to widely use a preliminary test protocol in poor unilateral gaze fixation (19 hexagons), which causes an increase in recording purity and, therefore, promotes the reliability of the findings.
