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M. Ritter, S. Sacu, G. Matt, R. Dunavoelgy, G. G. Deak, R. G. Sayegh, U. M. Schmidt-Erfurth; Association of Multifocal ERG and SD-OCT During Antiangiogenic Treatment of Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3581.
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To evaluate the association between different types of retinal morphologic alterations and functional changes during intravitreal anti-vascular endothelial growth factor (VEGF) therapy in patients with acute branch retinal vein occlusion (BRVO).
Twelve patients with significant macular edema secondary to BRVO were treated with one intravitreal injection of Ranibizmab (Lucentis, 0.05 ml) at baseline. The treatment was repeated at monthly intervals if decrease in visual acuity or an increase in central retinal thickness (CRT) as measured by SD-OCT (Cirrus, Carl Zeiss Meditec) was documented. During the 6-month follow up, a complete standardized ophthalmic evaluation was performed monthly including SD-OCT and multifocal electroretinography (mfERG, VERIS) at baseline month 3 and month 6. The 103 mfERG values were projected over the SLO image of the SD-OCT device allowing a direct correlation of functional and morphological parameters.
Within the entire study duration, the mean BCVA improved from 48 to 57 letters (p<0.01) on the Early Treatment in Diabetic Retinopathy Study (ETDRS) charts and the CRT decreased significantly (p<0.01). The mean area of reduced retinal response density of mfERG was reduced from 41% at baseline to 32% at month 6 (p<0.05). In SD-OCT, the main findings in the edematous macular area were diffuse thickening, cystic spaces in the outer nuclear layer (ONL), the inner nuclear layer (INL) and serous retinal detachment. All of the morphologic alterations demonstrated a significant negative effect on the corresponding localized retinal function as measured with mfERG (p<0.01). The greatest negative impact had serous retinal detachment followed by ONL cysts.
In macular edema secondary to BRVO, the presence of serous retinal detachment and ONL cysts have the greatest negative effect on functional recovery during antiangiogenic treatment.
Clinical Trial: :
EudraCT Nr. 2007-002826-31
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