June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Extrafoveal Changes Following Intravitreal Bevacizumab Injections for Macular Edema Secondary to Branch Retinal Vein Occlusion: A mfERG and OCT Study
Author Affiliations & Notes
  • Young-Hoon Ohn
    Soonchunhyang university hospital, Bucheon, Republic of Korea
  • Joo Hyun
    Soonchunhyang university hospital, Bucheon, Republic of Korea
  • Saemi Park
    Soonchunhyang university hospital, Bucheon, Republic of Korea
  • Tae Kwann Park
    Soonchunhyang university hospital, Bucheon, Republic of Korea
  • Footnotes
    Commercial Relationships Young-Hoon Ohn, None; Joo Hyun, None; Saemi Park, None; Tae Kwann Park, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3620. doi:
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      Young-Hoon Ohn, Joo Hyun, Saemi Park, Tae Kwann Park; Extrafoveal Changes Following Intravitreal Bevacizumab Injections for Macular Edema Secondary to Branch Retinal Vein Occlusion: A mfERG and OCT Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3620.

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

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Abstract
 
Purpose
 

To evaluate functional and structural changes of extrafoveal macula after intravitreal bevacizumab (IVB) injection in patients with macular edema due to branch retinal vein occlusion (BRVO) using multifocal electroretinogram (mfERG) and optical coherence tomography (OCT).

 
Methods
 

A total of 19 eyes of 19 patients with macular edema due to BRVO received three consecutive IVB injections with a 6-week interval. Spectral domain (SD)-OCT, mfERG, and fluorescein angiography (FA) were performed at baseline. The macular area was divided into four quadrants (Q1-Q4) based on FA. The mean retinal thickness (MRT) and mfERG parameters in each of the four quadrants were measured at baseline and 4 weeks after the third injection.

 
Results
 

The MRT in the four quadrants improved significantly after IVB injections (p < 0.01 for Q1 and Q2, p < 0.05 for Q3 and Q4) compared to baseline. The significant improvements in mfERG responses were seen in Q1 and Q2. In Q1, there were 68% and 56% improvement in N1 and P1 amplitude, respectively (p < 0.01). N1 and P1 amplitude in Q2 increased significantly by 43% and 46%, respectively, compared to baseline (p < 0.05). The MRT and P1 amplitude were significantly correlated at baseline in Q1 and Q2, but no significant correlations were found after three IVB injections.

 
Conclusions
 

The injection of intravitreal bevacizumab improved functional and structural outcomes in the primarily affected half of the extrafoveal macula effectively. The measurements of structural and functional changes using mfERG and OCT may be appropriate for monitoring the effects of IVB injection in BRVO patients.

 
 
(A) A circle with 3mm radius was superimposed on FA at baseline, corresponded to the mfERG hexagons in ring 1 to 4. Central fovea corresponding to a circle with 0.5mm radius in SD-OCT and ring 1 in mfERG stimulus array was excluded. (B) Example of MRT measurement. (C) Trace array of the first-order kernel responses in mfERG and selected seven hexagons in each quadrant were presented into gray circles. Excluded hexagons were indicated with gray boxes. (D) Mean responses in seven hexagons of each quadrant. (E-H) Angiographic, OCT and mfERG findings of the same patients at 4 weeks after the third IVB injection
 
(A) A circle with 3mm radius was superimposed on FA at baseline, corresponded to the mfERG hexagons in ring 1 to 4. Central fovea corresponding to a circle with 0.5mm radius in SD-OCT and ring 1 in mfERG stimulus array was excluded. (B) Example of MRT measurement. (C) Trace array of the first-order kernel responses in mfERG and selected seven hexagons in each quadrant were presented into gray circles. Excluded hexagons were indicated with gray boxes. (D) Mean responses in seven hexagons of each quadrant. (E-H) Angiographic, OCT and mfERG findings of the same patients at 4 weeks after the third IVB injection
 
 
Scatter plots showing the significant relationship between the MRT and the P1 amplitude at baseline in (A)Q1, (B)Q1+Q2, (C)Q3+Q4
 
Scatter plots showing the significant relationship between the MRT and the P1 amplitude at baseline in (A)Q1, (B)Q1+Q2, (C)Q3+Q4
 
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 509 electroretinography: clinical • 561 injection  
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