Multifocal electroretinographic findings in eyes with posterior uveitis and angiographic macular leakage

Abstract

Purpose : In this retrospective study, we used multifocal electroretinogram (mfERG) to evaluate the functional implications of angiographic macular leakage without presence of intraretinal fluid on optical coherence tomography (OCT) in eyes with posterior uveitis.

Methods : The STAnford Research Repository (STARR) database was used to identify subjects with posterior uveitis. Subjects who had fluorescein angiography (FA), OCT and mfERG were included, provided that FA and OCT were done at the same visit and mfERG was done within 1 month of the other two imaging modalities. Macular edema (ME) was defined as evidence of intraretinal fluid on OCT. Macular leakage on FA was referred to as angiographic macular leakage. The study cohort was then divided into two groups based on the presence of angiographic macular leakage and ME: Group 1 (no ME and no angiographic macular leakage) and group 2 (presence of angiographic macular leakage without ME). Baseline data, clinical criteria, and mfERG values were analyzed across both groups.

Results : Twenty-three patients (33 eyes) were included. Mean age was 35.9 (± 21.2) and 73% were female. There were 15 eyes in group 1 and 18 eyes in group 2. Groups 1 and 2 had an average age of 34.9 (± 21.0) and 36.7 (± 21.9), respectively (p>0.8). Underlying ocular conditions included retinal vasculitis (70%), panuveitis (26%) and intermediate uveitis (4%).

Mean central macular thickness and logMAR BCVA values were 266.6 (± 26.50) µm and 0.12 (± 0.14), respectively; differences were not statistically significantly between groups 1 and 2 (p>0.1 and p>0.7, respectively). mfERG ring 2 N1 implicit times were significantly delayed in group 2 as compared with group 1 (p<0.02). Other mfERG values did not show statistically significant differences between the two groups. Table 1 shows mfERG values of rings 1 (0^o) and 2 (3.5^o) for the two groups.

Conclusions : Angiographic macular leakage in posterior uveitis without intraretinal fluid on OCT can be associated with photoreceptor dysfunction detectable in the form of delayed implicit timings of ring 2 N1 waves in mfERG. Angiographic macular leakage can be a marker of disease activity and possibly an indication for treatment even in the absence of ME on OCT.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.