Abstract
Purpose :
The functional consequences of long-term, persistent vascular leakage in patients with uveitis remain unclear. To understand the effects of this leakage on photoreceptor and retinal function, we evaluated scotopic and photopic full-field ERG (ffERG) responses in uveitis patients with persistent angiographic vascular leakage.
Methods :
Participants were recruited under an IRB-approved protocol (NCT02656381). 16 patients with persistent angiographic leakage were selected for inclusion in this study. Subjects met the following inclusion criteria: (1) Diagnosis of intermediate, posterior, or panuveitis (patients with a diagnosis of Birdshot chorioretinopathy were excluded); (2) Three or more quadrants of retinal vascular leakage on ultra-wide field fluorescein angiography in at least one eye; (3) No history of prior retinal laser photocoagulation; (4) Persistent angiographic leakage on at least two subsequent angiograms; and (5) No history of retinal degeneration or dystrophy. Participants underwent ffERG according to ISCEV standard protocol. Scotopic and photopic a-wave and b-wave amplitudes, oscillatory potentials, and implicit times were measured in all patients.
Results :
29 eyes of 16 patients with persistent angiographic vascular leakage were included. Participants ranged in age from 20-74 with a median age of 39.5 years. Median visual acuity measured 0.00 logMAR (20/20 Snellen equivalent). Median duration of angiographic leakage was 14.5 months (range 1 – 76 mo.). 21 of 29 (72.4%) eyes from 13 of 16 patients displayed at least 2 abnormal ffERG values. A prolonged photopic 30-hertz flicker implicit time was observed in 22 of 29 eyes (75.9%). 18 eyes (62.1%) had a decreased scotopic a-wave amplitude (0 db flash). 18 eyes (62.1%) had a decreased scotopic b-wave amplitude (0 db flash). 13 eyes (44.8%) had decreased light adapted cone b-wave amplitude, and 13 eyes (44.8%) had a prolonged light adapted b-wave implicit time. Uveitis patients with persistent angiographic leakage had a median of 5.0 abnormal ffERG values per eye.
Conclusions :
Uveitis patients with persistent angiographic vascular leakage show evidence of photoreceptor dysfunction on ffERG testing indicating subclinical compromise of retinal function. ffERG may be a useful tool in monitoring patients and may have a potential to aid in treatment decisions.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.