June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Identifying High and Low Responders to Transcorneal Electrical Stimulation Treatment for Patients with Retinitis Pigmentosa
Author Affiliations & Notes
  • Lubka Naycheva
    Department for Ophthalmology, Azienda Sanitaria dell'Alto Adige, Brunico, Italy
  • Mariya Gosheva
    Department for Ophthalmology, Tübingen, Germany
  • Johanna Pach
    Katharinenhospital, Clinic for Ophthalomology, Stuttgart, Germany
  • Andreas Schatz
    Katharinenhospital, Clinic for Ophthalomology, Stuttgart, Germany
  • Eberhart Zrenner
    Department for Ophthalmology, Tübingen, Germany
  • Florian Gekeler
    Katharinenhospital, Clinic for Ophthalomology, Stuttgart, Germany
  • Footnotes
    Commercial Relationships Lubka Naycheva, Okuvision GmbH (C), Okuvision GmbH (C); Mariya Gosheva, Okuvision GmbH (F); Johanna Pach, Okuvision GmbH (F); Andreas Schatz, Okuvision GmbH (F); Eberhart Zrenner, Okuvision GmbH (F); Florian Gekeler, Okuvision GmbH (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3804. doi:
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      Lubka Naycheva, Mariya Gosheva, Johanna Pach, Andreas Schatz, Eberhart Zrenner, Florian Gekeler, ; Identifying High and Low Responders to Transcorneal Electrical Stimulation Treatment for Patients with Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3804.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To assess efficacy of treatment and explore high responders to transcorneal electrical stimulation (TES) in patients with retinitis pigmentosa (RP).

Methods: 63 eyes of 63 patients with RP (33 m, 30 f, age range 19-74) were treated with TES (5 ms + 5 ms biphasic pulses at 20 Hz). TES was applied for 30 minutes weekly for 52 consecutive weeks with an OkuEl®-transcorneal electrode and an OkuStim®-Device (Okuvision GmbH, Germany). Patients were randomly assigned to three study aims: TES with 0 mA (sham, n = 22); 150% (n = 21) or 200% (n = 20) of the individual electrical phosphene threshold (EPT) current at 20 Hz. Best corrected visual acuity, ophthalmological examination (slit-lamp biomicroscopy, fundus examination, Goldmann-applanation tonometry) and EPT were determined at baseline and at 8 following visits (at week 10, 16, 22, 28, 34, 40, 46 and 52). At 5 visits (at week 1, 16, 28, 40 and 52) kinetic visual field (VF) (Octopus 900®, Haag-Streit, Germany), optical coherence tomography (Spectralis®-OCT, Heidelberg Engineering GmbH, Germany), full-field electroretinography and dark adaptation were performed. To identify high responders, patients were divided into 3 groups according to the baseline size of the VF area using stimulus Goldmann III4e: small (234-2447 deg²), medium (2628-6792 deg²) and large (6806-14587 deg²) VF area.

Results: 52 patients (27 m, 25 f; TES = sham: n = 20, TES = 150%: n = 15 and TES = 200%: n = 17) completed the entire study. Using restricted maximum likelihood (REML) for estimation of changes under treatment (P < 0.05, Tukey-Kramer), in the group with small VF area (n = 18) a positive tendency for VF area enlargement (P = 0.14) was detected, but statistical significance was not reached. In the groups with medium (n = 18) and large (n = 18) VF area no such tendency was observed (respectively P = 0.62 and P = 0.21).

Conclusions: A positive tendency for an enlargement of VF area was observed in the group with the smallest VF area. However, results were not statistically significant. Particularly, patients with a smaller VF area (below ~27 deg) seem to benefit more from TES and could be classified as high responders.

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