Associations between multifocal electroretinogram (mfERG), optical coherence tomography (OCT) and standard automated perimetry (SAP) in non-acute Vogt-Koyanagi-Harada disease (VKHD)

Abstract

Purpose : To evaluate associations between functional (SAP and mfERG) and structural (OCT) measurements in patients with non-acute VKHD

Methods : Cross-sectional study (Jul/Dec 2017) with 18 patients with VKHD followed for mininum 12mo from disease onset with evaluation and treatment protocols. SAP was conducted using central 24-2 Swedish Interactive Threshold Algorithm standard on Humphrey Visual Field Analyzer II^®. Mean sensitivity (MS) was analyzed for 52 test points excluding points immediately above and below blind spot and central sensitivity (CS) was evaluated using average value at 4 central points. Values in decibel (dB) were converted to linear 1/L units. OCT with enhanced depth imaging was performed on Spectralis^® linear 30 degrees horizontal and vertical scanning of fundus area centered on macular umbo. mfERG (61 hexagons) was recorded using the RETiscan System^® following the International Society for Clinical Electrophysiology of Vision guidelines. P1 and N1 amplitudes and peak times were calculated after excluding ring 5 values. Age and gender matched controls were included for SAP and mfERG. Generalized estimated equations were used for analyzing binary ocular data, Pearson correlation for correlations and Bonferroni correction for multiple comparison. This study was approved by Institutional Ethics Committee and followed Helsinki declaration

Results : Table 1 presents clinical and exams data. Table 2 represents data of normal controls, VKHD patients and its associations. SAP and mfERG parameters were significantly worse in VKHD patients than in normal controls. There were significant correlations between P1 and N1 amplitudes and MS (r=0.342 and r=0.381, p=0.041 and p=0.022, respectively); P1 and N1 peak times and MS (r=-0.364 and r=-0.345, p=0.029 and p=0.039, respectively). Significant associations were also found between foveal thickness and N1 amplitude and P1 peak time (r=-0.354 and r=0.509, p=0.034 and p=0.002, respectively)

Conclusions : Measurements of SAP, mfERG and OCT correlated significantly with each other in patients with VKHD and were significantly worse than in controls. Disrupted photoreceptors integrity on OCT was associated with decreased P1 and N1 amplitudes and reduced values in all SAP parameters. Decreased P1 and N1 amplitudes and increased peak times were correlated with reduced MS

This is a 2020 ARVO Annual Meeting abstract.

 

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T2