Abstract
Abstract: :
Purpose: For continuous control of results of subretinal surgery with autologous RPE transplantation or PDT in patients with AMD we examined visual acuity (ETDRS charts), visual field, scotometry, optical coherence tomography (OCT), autofluorescence, fluorescein and indocyanine green angiographies. To further evaluate our results we additionally introduced multifocal electroretinographie (MERG). Methods: 87 eyes of 80 patients with AMD (group I and group II) underwent MERG before and after treatment in a regular pattern. Group I: 24 eyes from 24 patients were treated with membrane excision and simultaneous autologous RPE transplantation. Group II: 63 eyes from 56 patients were eligible for (TAP-study) and received PDT. In both groups each eye was examined before therapy and 1, 3, 6 month after treatment by MERG of the central retina (30°). To stimulate the retina we used a computer monitor that generates a pattern of hexagonal elements (altogether 103 fields), which may randomly change in contrast between white and black (m-sequences). Records were registered using DTL electrodes. Results: We observed a very good correlation between visual acuity and results of MERG in both groups. In group I maximal preoperative b-wave records of the macular region averaged 107 nV/deg2 and in the 1st, 3rd and 6th postoperative months 126, 137, 112 nV/deg2, respectively. In group II, the average pre-therapeutic value was 110 nV/deg2, and 124, 119, 106 nV/deg2 recorded in the 1st, 3rd and 6th months after treatment, respectively. The mean value of records in group I was postoperatively higher than before therapy. The peak records of b-wave amplitudes were observed in the 3rd post-operative month in group I and in the 1st post-PDT month in group II. Conclusion: MERG represent an important complementary method to the well-established examinations in both, RPE transplantation surgery and PDT. MERG as a reliable and precise quantitative method should be used in clinical macular diagnosis and in follow-up after retinal surgery.
Keywords: 395 electroretinography: clinical • 308 age-related macular degeneration • 346 choroid: neovascularization