Abstract
Purpose :
Previously, we have reported that the macular function assessed by the focal macular electroretinogram (fmERG) was correlated with thickness of parafoveal outer layer and serous retinal detachment (SRD) in patients with age-related degeneration (AMD). In addition, changes of SRD thickness by intravitreal injection of ranibizumab (IVR) most strongly affected the recovery of the macular function at 3 months after starting the treatment (Nishimura et al. Graefes Arch Clin Exp Ophthalmol 2014). In the present study, we shall investigate correlation between optical coherence tomographic (OCT) findings and macular function at 12 months after beginning IVR in AMD patients.
Methods :
We studied 28 eyes of 28 patients with AMD treated with IVR at monthly intervals for initial three months. Additional IVR was given according to a PRN regimen. The fmERG and OCT were performed before, 3 and 12 months after starting the treament. The fmERGs were elicited by a 15° white stimulus spot centered on the fovea. The thickness of the inner, middle and outer layer of the retina and also of the SRD and pigment epithelial detachment (PED) in the horizontal and vertical meridians at 1.2 mm from the fovea (parafoveal) was measured in the OCT images. The significance of the correlations between these structural parameters and the b-wave amplitude of the fmERG was determined.
Results :
The b-wave amplitude at 12 months was significantly correlated with thicknesses of outer layer, SRD and PED (outer layer: R= 0.62, P= 0.001, SRD: R= -0.49, P= 0.02, PED: R= -0.54, P= 0.003). The changes of b-wave amplitude between the baseline and 12 months was significantly correlated with the changes of SRD thickness between the baseline and 12 months (R= -0.51, P= 0.006). The changes of b-wave amplitude during PRN period was significantly and only correlated with the changes of PED thickness during PRN period (R= -0.40, P= 0.03).
Conclusions :
The parafoveal outer retinal and subretinal structures at 12 months were correlated with the macular function measured by the fmERG. Furthermore, even at 12 months after starting the treatment, improvement of SRD affected a recovery of macular function. Since recurrence of PED during the PRN period led to deterioration of the macular function, a control of PED is necessary for favorable recovery of the macular function after IVRs.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.