Transcorneal electrical stimulation improves visual function in eyes with branch retinal artery occlusion

Oono, Shinichirou; Kurimoto, Takuji; Kashimoto, Ryousuke; Tagami, Yuichi; Okamoto, Norio; Mimura, Osamu

doi:10.2147/opth.s17751

Cited by 29 publications

(18 citation statements)

References 17 publications

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“…In their studies with RAO patients, Inomata et al [13] and Oono et al [15] used stimulation currents ranging from 0.50 to 1.10 mA. These values are, remarkably, comparable to the values used in the present study, despite significant differences in techniques.…”

Section: Discussionsupporting

confidence: 80%

Transcorneal Electrical Stimulation in Patients with Retinal Artery Occlusion: A Prospective, Randomized, Sham-Controlled Pilot Study

et al. 2013

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IntroductionThe purpose of this study was to investigate the safety and efficacy of transcorneal electrical stimulation (TES) in patients suffering from retinal artery occlusion (RAO).MethodsTwelve patients with central and one patient with branch RAO (age 25–84 years, median 74 years) were enrolled in this prospective, randomized, sham-controlled study. RAO was diagnosed 10 days to 17 months prior to study participation. Patients were treated with TES (5 ms positive followed by 5 ms negative biphasic pulses at 20 Hz; applied with DTL electrodes) for 30 min once a week for 6 consecutive weeks. Patients were randomly assigned to TES with 0 mA (sham, n = 3), 66% (n = 5) or 150% (n = 5) of the patient’s individual electrical phosphene threshold (EPT) at 20 Hz. Best corrected visual acuity, ophthalmology examination and EPT (at 3, 6, 9, 20, 40, 60, and 80 Hz) were determined at baseline and at eight follow-up visits over 17 weeks. During four visits (week 1, 5, 9, and 17) kinetic and static visual fields as well as full-field and multifocal electroretinography were measured. The method of restricted maximum likelihood (P < 0.05, Tukey–Kramer) was used to estimate the development of parameters under treatment.ResultsTES was tolerated well; no ocular or systemic adverse events were observed except for foreign-body sensation after TES (n = 3). During the study period the slopes of the scotopic a-wave increased significantly (high-intensity flash white 10 cd.s/m2; P = 0.03) in the 150% treatment group. All other parameters in all other groups remained statistically unchanged.ConclusionsAlthough TES was tolerated well, statistically significant improvements were found only for specific a-wave slopes. This is in contradiction to previous smaller, uncontrolled reports. Further studies with larger sample sizes and longer duration might, however, show additional significant effects.

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Section: Discussionsupporting

confidence: 80%

Transcorneal Electrical Stimulation in Patients with Retinal Artery Occlusion: A Prospective, Randomized, Sham-Controlled Pilot Study

et al. 2013

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“…TES has been reported to improve visual function in humans with retinal artery occlusion, non-arteritic ischaemic optic neuropathy and traumatic optic neuropathy, 11–13 as well as inherited retinal dystrophies, such as Best vitelliform macular dystrophy. 14 In RP, an initial pilot study assessing six sessions of weekly TES in eight participants showed significant improvements in kinetic perimetry and scotopic ERG function.…”

Section: Introductionmentioning

confidence: 99%

Transcorneal electrical stimulation for the treatment of retinitis pigmentosa: results from the TESOLAUK trial

et al. 2017

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ObjectiveTo explore the impact of weekly transcorneal electrical stimulation (TES) over a 6-month period as a treatment for retinitis pigmentosa (RP).Methods and analysisA prospective open-label observational trial was carried out assessing weekly TES in participants with RP for a period of 6 months followed by observation for a further 6 months. Clinical examination and investigations were carried out at 3 monthly intervals for a total of 12 months. The primary outcome measure explored safety through a descriptive analysis of adverse effects with secondary outcome measures evaluating structural and functional efficacy.ResultsSeven male and seven female participants with RP aged 18–80 years were recruited. TES was well tolerated with no serious adverse events reported. Two participants reported transient foreign body sensation and one participant had discomfort underneath the skin electrode. Following 6 months of TES, best-corrected visual acuity increased by 1.1±1.4 letters in the control arm and 0.93±1.4 letters in the treated arm. Central microperimetry threshold sensitivity rose by 0.02±0.5 decibels (dB) and 0.37±0.4 dB and Goldmann visual field volume by 0.16±0.09 steradians (sr) vs 0.22±0.12 sr for the control and treated eye, respectively. There was no statistical significance seen between eyes following the treatment or observation period.ConclusionThis small open-label clinical trial showed that TES was safe and well tolerated in patients with RP. Visual function measurements at 6 months demonstrated no significant difference between the control and treated eyes. The results justify a larger clinical trial over a longer period of time in order to identify any treatment effect.

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“…All studies were small; some had sham controls. Effective use of TES for eye conditions included nonarteritic ischemic neuropathy, 14 branch retinal vein occlusion, 15 Stargardt’s disease, 16 retinitis pigmentosa, 17 and Best vitelliform retinopathy. 18 Frequency-specific microcurrent (FSM) has been used extensively in the field of physical medicine and rehabilitation for pain relief and accelerating tissue recovery.…”

Section: Introductionmentioning

confidence: 99%

Microcurrent stimulation in the treatment of dry and wet macular degeneration

Chaikin

Kashiwa²,

Bennet³

et al. 2015

OPTH

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PurposeTo determine the safety and efficacy of the application of transcutaneous (transpalpebral) microcurrent stimulation to slow progression of dry and wet macular degeneration or improve vision in dry and wet macular degeneration.MethodsSeventeen patients aged between 67 and 95 years with an average age of 83 years were selected to participate in the study over a period of 3 months in two eye care centers. There were 25 eyes with dry age-related macular degeneration (DAMD) and six eyes with wet age-related macular degeneration (WAMD). Frequency-specific microcurrent stimulation was applied in a transpalpebral manner, using two programmable dual channel microcurrent units delivering pulsed microcurrent at 150 µA for 35 minutes once a week. The frequency pairs selected were based on targeting tissues, which are typically affected by the disease combined with frequencies that target disease processes. Early Treatment Diabetic Retinopathy Study or Snellen visual acuity (VA) was measured before and after each treatment session. All treatment was administered in a clinical setting.ResultsSignificant increases were seen in VA in DAMD (P=0.012, Wilcoxon one-sample test), but in WAMD, improvements did not reach statistical significance (P=0.059). In DAMD eyes, twice as many patients showed increase in VA (52%) compared to those showing deterioration (26%), with improvements being often sizeable, whereas deteriorations were usually very slight. In WAMD eyes, five of six (83%) patients showed an increase and none showed deterioration.ConclusionThe substantial changes observed over this period, combined with continued improvement for patients who continued treatment once a month, are encouraging for future studies. The changes observed indicate the potential efficacy of microcurrent to delay degeneration and possibly improve age-related macular degeneration, both wet and dry. However, this study has no control arm, so results should be treated with caution. Randomized double-blind controlled studies are needed to determine long-term effects.

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Transcorneal electrical stimulation improves visual function in eyes with branch retinal artery occlusion

Cited by 29 publications

References 17 publications

Transcorneal Electrical Stimulation in Patients with Retinal Artery Occlusion: A Prospective, Randomized, Sham-Controlled Pilot Study

Transcorneal Electrical Stimulation in Patients with Retinal Artery Occlusion: A Prospective, Randomized, Sham-Controlled Pilot Study

Transcorneal electrical stimulation for the treatment of retinitis pigmentosa: results from the TESOLAUK trial

Microcurrent stimulation in the treatment of dry and wet macular degeneration

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