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Shigeki Machida, Kunifusa Tamada, Tomoharu Nishimura, Takamitsu Fujiwara, Daisuke Yokoyama, Daijiro Kurosaka; Macular Function Evaluated by Focal Macular Electroretinograms after Reduced Fluence Photodynamic Therapy in Eyes with Poplypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3505.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the macular function by the focal macular electroretinograms (ERGs) after reduced fluence photodynamic therapy (RFPDT) in Japanese patients with polypoidal choroidal vasculopathy.
We studied 12 eyes of 12 patients with PCV in which the diameter of the lesion was less than 3,500 µm. Their ages ranged 62 to 85 years with a mean of 75 years. The exposure time was reduced to 42 sec so that the total energy of the laser was approximately one-half of the standard PDT dosage. We measured the visual acuity, foveal thickness, and focal macular ERGs before and after the RFPDT. The focal macular ERGs were elicited by a 15° white stimulus spot centered on the macula. The rate of recurrence of exudative changes was determined one year after the RFPDT.
The visual acuities improved gradually postoperatively. A significant recovery of vision was seen even at 1 week after RFPDT (P<0.05). The foveal thickness was reduced even 1 week after the treatment (P<0.005), and became significantly thinner with increasing time (P<0.05). The amplitudes of the a- and b-waves were significantly reduced with significantly prolonged implicit times at the baseline compared to the unaffected normal fellow eyes. A slight recovery of the a- and b-wave amplitudes was seen postoperatively without a transient reduction of the amplitudes. The b-wave amplitude was significantly larger at 3 months after the treatment (P<0.05). Indocyanine green angiography showed that choroidal hypoperfusion did not develop 3 months postoperatively. A recurrence of the exudative changes was detected in 6 out of 12 eyes, and these required additional treatments.
RFPDT provides short-term benefits in PCV patients with small lesions. Maintenance of the macular function was achieved after RFPDT without the transient decrease of function. These findings indicate that RFPDT can be used to treat PCV patients with relative good vision.
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