Multifocal Electroretinogram Findings after Intravitreal Bevacizumab Injection in Choroidal Neovascularization of Age-Related Macular Degeneration

Park, Joo Youn; Kim, Seung Hoon; Park, Tae Kwann; Ohn, Young-Hoon

doi:10.3341/kjo.2011.25.3.161

Cited by 10 publications

(7 citation statements)

References 25 publications

(36 reference statements)

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“…In the literature, mERG results after anti-VEGF treatment have shown opposing results. MERG results, similar to the outcomes of the present study, have been published previously for other anti-VEGF agents and treatment regimens, and with a shorter follow-up time; after one or three injections of either bevacizumab or ranibizumab [19][20][21], after 6 months with consecutive ranibizumab, bevacizumab or both drugs [6,7,22], and as a 1-year evaluation of continuous treatment with ranibizumab [23,24]. Yet another 12-month study has used a bimonthly aflibercept regimen comparable to arm 1 in the present study [25].…”

Section: Discussionsupporting

confidence: 89%

Electrophysiological evaluation and 18-month follow-up of two regimens with aflibercept for neovascular age-related macular degeneration

2022

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Purpose To compare two aflibercept treatment regimens and the electrophysiological outcome concerning cone and rod function in age-related macular degeneration (nAMD) over 18 months. Methods 41 patients with treatment-naïve nAMD were randomized 1:1 to either arm 1 or 2. Arm 1 received three consecutive monthly aflibercept injections, followed by bimonthly treatment until week 52. Thereafter, a treat-and-extend (TAE) regimen was applied. Arm 2 was treated according to a TAE protocol throughout the 18-month follow-up. We assessed visual acuity (VA), central retinal thickness (CRT), injection rate and interval, and evaluated cone and rod function with full-field and multifocal electroretinography (ffERG, mERG). Results There were no statistically significant differences in mean baseline VA, lesion type, age, gender, or symptom duration between the two arms. During the 18-month follow-up, mean VA improved in arm 1 (n = 19) from 63.5 ± 10.5 to 69.1 ± 9.2 letters; p = 0.098; and in arm 2 (n = 20) from 66.8 ± 13.6 to 73.9 ± 9.0 letters; p = .002. In both arms, mean CRT was significantly reduced; p < 0.000. At month 18, we found no significant difference in the number of injections or injection intervals between groups. Arm 1 had received 11.3 ± 1.7 injections vs. 10.9 ± 2.0 in arm 2. The mean injection interval was 9.2 ± 3.4 weeks vs. 9.5 ± 3.1, with 52% (n = 10) on the maximum 12-week interval in arm 1, and 50% (n = 10) in arm 2. The combined rod-cone a-wave amplitude significantly decreased over time; p = 0.043. The isolated rod b-wave amplitude showed a statistically significant decline; p = 0.026. The overall mERG amplitude and implicit time remained unchanged over time; p = 0.878 vs. p = 0.922. The central ring 1 mERG amplitude improved; p = 0.041, with an unaffected implicit time. Conclusions After 18 months, both treatments arms have received a similar number of injections at comparable intervals. Electrophysiological evaluation shows no signs of toxicity concerning cone function. But ffERGs for the combined and isolated rod response have declined, possibly reflecting either toxic effects of the drug to rods or the natural course of the disease itself.

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Section: Discussionsupporting

confidence: 89%

Electrophysiological evaluation and 18-month follow-up of two regimens with aflibercept for neovascular age-related macular degeneration

2022

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“…In this study, retinal electrophysiologic parameters measured by mfERG, particularly the implicit time, but not the amplitude, were different in the Aβ+CN vs the Aβ−CN participants, suggesting that not only retinal structure, but also retinal function, undergo changes from the asymptomatic stage of AD. Implicit time, but not amplitude, is known to be a more sensitive parameter to evaluate injury in degenerative diseases of the receptors and is more susceptible than amplitude in various diseases, including retinitis pigmentosa, macular dystrophy, and diabetes . Thus, our finding suggests that delayed implicit time is a potential sensitive indicator of early retinal neuronal change related to cerebral Aβ deposition.…”

Section: Discussionmentioning

confidence: 69%

Association of Retinal Changes With Alzheimer Disease Neuroimaging Biomarkers in Cognitively Normal Individuals

Byun

Park

Lee³

et al. 2021

JAMA Ophthalmol

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IMPORTANCERetinal biomarkers reflecting in vivo brain Alzheimer disease (AD) pathologic abnormalities could be a useful tool for screening cognitively normal (CN) individuals at the preclinical stage of AD.OBJECTIVES To investigate the association of both functional and structural alterations of the retina with in vivo AD pathologic abnormalities in CN older adults and model a screening tool for detection of preclinical AD.

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“…In the control group, the right or left eye was enrolled in alternative fashion. Patients with nvAMD were selected for this study because it is well known that this disease show pathologic changes on mfERG [ 8 , 12 , 13 ]. Patients with spherical equivalent refraction of ±3 diopters were excluded in both groups, trying to make more homogeneous groups.…”

Section: Methodsmentioning

confidence: 99%

Structure versus function: correlation between outer retinal and choroidal thicknesses measured by swept-source OCT with multifocal electroretinography and visual acuity

et al. 2017

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BackgroundTo correlate retina-choroidal anatomy as assessed via swept-source OCT (SS-OCT) with retinal function as determined by best-corrected visual acuity (BCVA) and multifocal electroretinogram (mfERG).MethodsThirty-three eyes from 33 patients including 16 with neovascular AMD (nvAMD) and 17 controls were included. Patients were included in the present study after a complete ophthalmologic examination, including BCVA, slit-lamp study, intraocular pressure measurement, dilated fundus examination after tropicamide instillation, SD-OCT, SS-OCT, fundus photographs and mfERG. Age, sex, BCVA, number of anti-VEGF intravitreal injections in the nvAMD group, were recollected. Outer retinal and choroidal thickness were determined at the fovea and 500 μm temporal, superior, nasal and inferior. First-order response from mfERG was collected. P1 amplitude was recorded in R1, R2 and the average of R1 + R2. The measurements recollected from the SS-OCT, mfERG and BCVA were compared.ResultsBetter BCVA was found with thicker outer retina foveal thickness (r = 0.349; P = 0.047), with thicker subfoveal choroidal thickness (r = 0.443; P = 0.010), and with higher amplitude in P1 at R1 (r = 0.346; P = 0.037). Outer retina foveal thickness did not correlate with P1 amplitude at R1 (r = 0.072; P = 0.692), R2 (r = 0.265; P = 0.137) either with the average P1 amplitude at R1 + R2 (r = 0.253; P = 0.156). A thicker subfoveal choroidal thickness was related with higher amplitude in P1 at R1 (r = 0.383; P = 0.028), R2 (r = 0.409; P = 0.018) and the average of R1 + R2 (r = 0.419; P = 0.015).ConclusionsChoroidal thickness demonstrated a positive correlation with retinal function in the sample studied, so a thicker choroid is related to a better retinal function measured with mfERG and BCVA.

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Multifocal Electroretinogram Findings after Intravitreal Bevacizumab Injection in Choroidal Neovascularization of Age-Related Macular Degeneration

Cited by 10 publications

References 25 publications

Electrophysiological evaluation and 18-month follow-up of two regimens with aflibercept for neovascular age-related macular degeneration

Electrophysiological evaluation and 18-month follow-up of two regimens with aflibercept for neovascular age-related macular degeneration

Association of Retinal Changes With Alzheimer Disease Neuroimaging Biomarkers in Cognitively Normal Individuals

Structure versus function: correlation between outer retinal and choroidal thicknesses measured by swept-source OCT with multifocal electroretinography and visual acuity

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