July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Association between number of injections during long-term anti VEGF therapy and retinal electrophysiological parameters
Author Affiliations & Notes
  • Angharad Elizabeth Hobby
    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
    Department of Ophthalmology, St Thomas’ Hospital, London, United Kingdom
  • Byki Huntjens
    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
  • Omar Abdul Rahman Mahroo
    Department of Ophthalmology, St Thomas’ Hospital, London, United Kingdom
    Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London, United Kingdom
  • David P Crabb
    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
  • Alison M Binns
    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Angharad Hobby, None; Byki Huntjens, None; Omar Mahroo, None; David Crabb, Allergan (R), CenterVue (C), Roche (F), Santen (R); Alison Binns, None
  • Footnotes
    Support  The College of Optometrists
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1446. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Angharad Elizabeth Hobby, Byki Huntjens, Omar Abdul Rahman Mahroo, David P Crabb, Alison M Binns; Association between number of injections during long-term anti VEGF therapy and retinal electrophysiological parameters. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1446.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Some studies report a reduction in retinal ganglion cell layer thickness during long-term antiVEGF therapy in neovascular age-related macular degeneration (nAMD). We explored whether electroretinogram (ERG) parameters, including those derived from ganglion cells, were related to number of injections.

Methods : Patients undergoing antiVEGF treatment for nAMD were recruited from medical retina clinics. Photopic ERGs were recorded following mydriasis, using conductive fibre electrodes. Ganzfeld stimuli were delivered (ColorDome, Diagnosys, Lowell, MA), including 41Hz flicker (30cd.m-2, 635nm), international standard photopic flashes (3cd.s.m-2, white) and stimuli to elicit a photopic negative response (PhNR; red stimulus, 635nm, 0.42cd.s.m-2, blue background, 465nm, 158.8cd.m-2). Associations between number of injections and ERG parameters were evaluated (Spearman correlation). In a subsequent study, patients were recruited from another medical retina clinic and underwent PhNR recordings (1.5cd.s.m-2red flashes; 10 cd.m-2 blue background) using a hand-held device (RETeval, LKC Technologies Inc., Gaithersburg, MD) and skin electrodes.

Results : In the first study, recordings were made on 31 patients with median (interquartile range[IQR]) age 84 (74, 86) years. Median (IQR) number of prior anti-VEGF injections was 9 (3, 14). Correlation between PhNR amplitude and number of injections was statistically significant (rho=-0.50; p=0.007): amplitude decreased with increasing injections. No other parameters showed significant correlations. In the second study, 25 patients were examined but only 20 produced reliable recordings, and one more was excluded because of incomplete injection data. In this cohort (n=19, median[IQR] age 78 [69,85] years; median[IQR] 6 [2,14] prior injections), many recordings exhibited noise. No significant correlation was seen between PhNR amplitude and number of injections.

Conclusions : PhNR measures cone-driven ganglion cell function. Reduced amplitudes with increasing injections in this cross-sectional study are consistent with reduced ganglion cell function in long-term therapy. In the second study, no significant association was found, possibly due to different stimulus parameters or the substantially poorer signal-to-noise ratio with skin electrodes. The findings invite further exploration in a larger, longitudinal study.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×