Early changes in photopic negative response in eyes with glaucoma with and without choroidal detachment after filtration surgery

Igawa, Yuro; Shoji, T.; Weinreb, Robert N.; Miyake, Yoichi; Yoshikawa, Yuji; Takano, Shigeru; Shinoda, Kei

doi:10.1136/bjophthalmol-2021-320730

Cited by 5 publications

(6 citation statements)

References 31 publications

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“…22 We showed that the ERGs recorded with a skin electrode can be used to evaluate the retinal function in the early postoperative period even in eyes after ltration surgery in which contact lenses and DTL electrodes cannot be used. 15,23,24 These were only two cases, and the safety and effectiveness of this treatment cannot be applied to all cases because there are many factors that in uence the presence of endophthalmitis. It is necessary to investigate a larger number of cases to determine whether a recurrence of endophthalmitis can be resolved and prevented by this method.…”

Section: Discussionmentioning

confidence: 99%

“…To overcome this problem, skin electrodes can be used to record the ERGs without affecting the ltering bleb and avoid the risk of infection. 15 We present the results of pars plana vitrectomy (PPV) with irrigation of 0.025% PI in balanced salt solution (BSS) PLUS (Alcon Laboratories, Fort Worth, TX) in two cases of bleb-related endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

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Electroretinographic evaluations of bleb-related endophthalmitis after vitrectomy with 0.025% povidone iodine irrigation

Sakata,

Katsumoto,

Kumagai

et al. 2024

Preprint

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Background Vitrectomy with 0.025% povidone-iodine (0.025% PI) in the irrigation solution was recently reported to be used to treat filtering bleb-associated endophthalmitis. However, iodine is known to be retinotoxic but it depends on its concentration. Electroretinography (ERGs) can be used to evaluate the retinal function, but the contact lens electrodes used to pick up the ERGs can affect the filtering bleb adversely. We performed ERGs with skin electrodes on eyes with bleb-associated endophthalmitis that had undergone vitrectomy with 0.025% PI irrigation.Case presentation: Case 1 was a 46-year-old man who underwent trabeculectomy for steroid induced glaucoma. One month postoperatively, a filtering bleb-associated endophthalmitis was suspected, and vitreal and subconjunctival injections of vancomycin (VCM) and ceftazidime (CAZ), and frequent antibiotic eye drops were started. After three days, an exacerbation of the endophthalmitis was observed and vitrectomy with 0.025% PI irrigation was performed. One month after the surgery, the visual acuity improved from hand movements to counting fingers. Pre- and postoperative ERGs recorded using skin electrodes showed an improvement in the a- and b-wave amplitudes and the b/a ratio was stable at approximately 2.0. Case 2 was a 63-year-old man who had undergone phacovitrectomy for proliferative diabetic retinopathy eleven years earlier and trabeculectomy for glaucoma five years earlier in the left eye. Five years after the surgery, the eye developed blebitis, and frequent antibiotic eye drops and subconjunctival injections of VCM and CAZ were performed. Three days later, vitreous opacities appeared and a high brightness area was observed in the B-mode echo images. A diagnosis of bleb-associated endophthalmitis was made, and vitrectomy with 0.025% PI irrigation was performed. The preoperative visual acuity was hand movements, and it improved to 0.01 one month after the surgery. Comparisons of the postoperative to the preoperative ERGs found that the a- and b- wave amplitudes increased and the b/a ratio was stable at approximately 1.5 postoperatively.Conclusions ERG recordings with skin electrodes are helpful for evaluating postoperative retinal function in cases of bleb-associated endophthalmitis. Vitrectomy with 0.025% PI irrigation is effective and most likely safe for the treatment of bleb-associated endophthalmitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Electroretinographic evaluations of bleb-related endophthalmitis after vitrectomy with 0.025% povidone iodine irrigation

Sakata,

Katsumoto,

Kumagai

et al. 2024

Preprint

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“…Recently, PhNR was used to assess RGC function in patients with glaucoma and detected an improvement in inner retinal function after 12 weeks of oral nicotinamide supplementation compared to baseline [ 62 ]. Igawa and co-workers [ 63 ] showed an increase in PhNR amplitude in the first week after filtration surgery with a mean decrease in IOP of 50% from baseline, indicating rapid functional improvement. In our study, we found no significant changes in ERG parameters after lowering IOP.…”

Section: Discussionmentioning

confidence: 99%

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

Daka,

Sustar Habjan,

Meglič

et al. 2024

JCM

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(1) Background: Given the global prevalence of glaucoma and the crucial role of intraocular pressure (IOP) reduction in the management of the disease, understanding the immediate effects on retinal structure and function is essential. (2) Methods: This study aimed to assess the effects of preservative-free latanoprost on morphological and functional parameters in treatment-naïve patients with ocular hypertension and open-angle glaucoma. (3) Results: This study showed a significant reduction in IOP by an average of 30.6% after treatment with preservative-free latanoprost. Despite the significant reduction in IOP, no statistically significant changes were observed in the electroretinogram (ERG) nor the optical coherence tomography/angiography (OCT/OCTA) parameters compared to baseline. An exploration of the correlation between IOP changes and various parameters revealed a significant association solely with the macular IPL/INL plexus vessel density (VD) measured with OCTA. (4) Conclusions: This finding suggests a possible association between IOP reduction and changes in the macular microcirculation and provides valuable insights into the differential effects of latanoprost. Acknowledging the study limitations, this study emphasizes the need for larger, longer-term investigations to comprehensively assess the sustained effects of preservative-free latanoprost on both IOP and retinal parameters. In addition, exploring systemic factors and conducting subgroup analyses could improve personalized approaches to glaucoma treatment.

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“…21 We showed that the ERGs recorded with skin electrode can be used to evaluate the retinal physiology in the early postoperative period even in eyes after filtration surgery in which contact lenses and DTL electrodes cannot be used. 12,22,23 Dense opacities, such as that caused by hemorrhage, mature cataracts, or thick fibrous membranes, can reduce the ERG responses. So the effects of media opacities should be considered when comparing the ERGs in some cases.…”

Section: Dovepressmentioning

confidence: 99%

“…To overcome this difficulty, skin electrodes are used to record the ERGs without affecting the filtering bleb and avoid exposing infectious microorganisms to the bleb. 12 The purpose of this report is to present our findings in two cases of extraneous endophthalmitis that were treated with pars plana vitrectomy (PPV) with irrigation of 0.025% PI diluted in balanced salt solution (BSS) PLUS (Alcon Laboratories, Fort Worth, TX). The status of the retinal physiology was determined by full-field ERGs that were recorded with the RETeval system and skin electrodes before and after the vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

Electroretinographic Evaluations Using Skin Electrode of Eyes with Bleb-Related Endophthalmitis Following Vitrectomy with 0.025% Povidone Iodine Irrigation

Sakata,

Katsumoto,

Kumagai

et al. 2024

IMCRJ

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To determine whether 0.025% povidone-iodine (0.025% PI) in the irrigation solution during vitrectomy for endophthalmitis is safe. Methods: Two cases of bleb-associated endophthalmitis were treated with vitrectomy using 0.025% PI in the irrigation solution. The RETevel electroretinographic (ERG) system with skin electrodes was used to assess the physiology of the retina pre-and postoperatively. Case: Case 1 was a 46-year-old man who had atopic keratoconjunctivitis and underwent trabeculectomy with the creation of a bleb after there was a rise in the intraocular pressure. One month postoperatively, a mild filtering bleb-associated endophthalmitis developed, and the eye was treated with intravitreal and subconjunctival injections of vancomycin (VCM) and ceftazidime (CAZ). After three days, the fundus was not visible and B-mode echography showed an area of high brightness in the retina. Vitrectomy with irrigation with VCM and CAZ, and 0.025% PI was performed successfully. Pre-and postoperative ERGs showed an improvement in both the a-and b-wave amplitudes and the b/a ratio was stable at 2.0. Case 2 was a 63-year-old man who had undergone trabeculectomy for glaucoma. Five years later, the eye developed blebitis which was treated with topical and subconjunctival injections of VCM and CAZ. Three days later, vitreous opacities appeared and a high brightness area was seen in the B-mode echographic images. Vitrectomy with VCM and CAZ, and 0.025% PI irrigation was successfully performed. Comparisons of the pre-and postoperative ERGs found that the a-and b-wave amplitudes of the ERGs increased and the b/a ratio was stable at approximately 1.5. Conclusion: Vitrectomy with 0.025% PI irrigation is safe and ERG recordings with skin electrodes can be used to evaluate the preand postoperative retinal physiology safely.Plain Language Summary: We report our findings in two cases of bleb-related endophthalmitis that underwent pars plana vitrectomy (PPV) with irrigation with 0.025% povidone-iodine (PI)-Balanced Salt Solution (BSS) PLUS (Alcon Laboratories, Fort Worth, TX). The retinal function was evaluated by full-field electroretinograms (ERGs) recorded with skin electrodes before and after the vitrectomy.At present, there is no consensus on whether patients with bleb-related endophthalmitis should be treated with PPV or treated solely by intravitreal antibiotics. It was recently reported that vitrectomy using an irrigation solution containing 0.025% PI followed by postoperative antibiotics was effective and safe for the treatment of endogenous endophthalmitis and postoperative endophthalmitis. However, iodine is known to be retinotoxic depending on its concentration.Electroretinography is a useful method to evaluate the safety of medications because it represents the physiology of the entire retina. However, conventional recording procedures with contact lens electrodes cannot be used in eyes with bleb associated endophthalmitis. Therefore, we performed ERG using skin electrodes which were introduced relatively recently. As a resul...

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Early changes in photopic negative response in eyes with glaucoma with and without choroidal detachment after filtration surgery

Cited by 5 publications

References 31 publications

Electroretinographic evaluations of bleb-related endophthalmitis after vitrectomy with 0.025% povidone iodine irrigation

Electroretinographic evaluations of bleb-related endophthalmitis after vitrectomy with 0.025% povidone iodine irrigation

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

Electroretinographic Evaluations Using Skin Electrode of Eyes with Bleb-Related Endophthalmitis Following Vitrectomy with 0.025% Povidone Iodine Irrigation

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