scholarly journals Evaluation of Macular Function after Vitrectomy in Diabetic Macular Edema

2021 ◽  
Vol 5 (1) ◽  
pp. 18-26
Author(s):  
Mona Abdelkader ◽  
◽  
Mohamed Mamdouh ◽  
Ayman Fawzy
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
Multifocal Electroretinogram ◽  
Diabetic Macular Oedema ◽  
Implicit Time ◽  
Diabetic Patients ◽  
Functional Evaluation ◽  
Macular Function ◽  
Full Field ◽  
Before And After

Purpose: To document the effects of successful vitrectomy on retinal function and anatomy in diabetic patients. Methods: Three-port pars plana vitrectomy with detachment of posterior vitrous face was performed in 30 eyes of 25 patients with diabetic macular oedema DME (11 male, 14 Female).For each patients, visual acuity (VA) examination, measurement of retinal thickness using optical coherence tomography (OCT), full field electro-retinogram (ERG) and multifocal eletroretinogram (MF-ERG) were performed before and 1week,1month and 3months after vitrectomy. Results: Mean postoperative visual acuity was significantly improved (P<0.05); mean retinal thickness was significantly (P=0.001 ) decreased after 3monthes of surgery (from 450±150 into 220±50 micron ) .b-wave amplitudes of all cone and rod responses of ERG were significantly decreased in all vitrectomized eyes after 1 week. At one month, rod response was still unimproved but improved after 3months. Reduction in foveal Function as well as in para-foveal areas detected in the MF-ERG within 1st month. Then, mean P1 wave amplitude of MF-ERG of central ring increased and mean P1 wave implicit time decreased. These changes of MF-ERG parameters observed 3 months after vitrectomy. Conclusion: Multifocal electroretinogram can be useful to provide objective criteria for functional evaluation before and after vitrectomy in diabetic oedema.

scholarly journals Multifocal Electroretinogram Can Detect the Abnormal Retinal Change in Early Stage of type2 DM Patients without Apparent Diabetic Retinopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jiang Huang ◽  
Yi Li ◽  
Yao Chen ◽  
Yuhong You ◽  
Tongtong Niu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Early Stage ◽  
Multifocal Electroretinogram ◽  
Implicit Time ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Retinal Change

Purpose. To study retinal function defects in type 2 diabetic patients without clinically apparent retinopathy using a multifocal electroretinogram (mf-ERG). Methods. Seventy-six eyes of thirty-eight type 2 diabetes mellitus(DM) patients without clinically apparent retinopathy and sixty-four normal eyes of thirty-two healthy control (HC) participants were examined using mf-ERG. Results. Patients with type 2 DM without apparent diabetic retinopathy demonstrated an obvious implicit time delay of P1 in ring 1, ring 3, and ring 5 compared with healthy controls ( t = 5.184 , p ≤ 0.001 ; t = 8.077 , p ≤ 0.001 ; t = 2.000 , p = 0.047 , respectively). The implicit time (IT) in ring 4 of N1wave was significantly delayed in the DM group ( t = 2.327 , p = 0.021 ). Compared with the HC group, the implicit time of the P1 and N1 waves in the temporal retina zone was significantly prolonged ( t = 3.66 , p ≤ 0.001 ; t = 2.187 , p = 0.03 , respectively). And the amplitude of P1 in the temporal retina decreased in the DM group, which had a significantly statistical difference with the healthy controls ( t = − 6.963 , p ≤ 0.001 ). However, there were no differences in either the amplitude of the response or the implicit time of the nasal retina zone between DM and HC. The AUC of multiparameters of mf-ERG was higher in the diagnosis of DR patients. Conclusions. Patients with type 2 DM without clinically apparent retinopathy had a delayed implicit time of P1 wave in temporal regions of the postpole of the retina compared with HC subjects. It demonstrates that mf-ERG can detect the abnormal retinal change in the early stage of type2 DM patients without apparent diabetic retinopathy. Multiparameters of mf-ERG can improve the diagnostic efficacy of DR, and it may be a potential clinical biomarker for early diagnosis of DR.

scholarly journals The effect of phacoemulsification of bilateral cataracts, performed at different intervals, on the macular area of the retina

2020 ◽  
Vol 13 (1) ◽  
pp. 23-28
Author(s):  
I. E. Ioshin ◽  
A. I. Tolchinskaya ◽  
A. M. Bagirov
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinal Thickness ◽  
Vision System ◽  
Central Retinal Thickness ◽  
Macular Area ◽  
Scanning Protocol ◽  
Significant Difference ◽  
Before And After ◽  
Retinal Examination

Purpose. A comprehensive assessment of the state of macular retina after phacoemulsification of two eyes performed at different intervals between operations according to optical coherence tomography (OCT) data. Materials and methods. We examined 93 patients (186 eyes) aged 65.7 ± 1.6 years with bilateral age cataract after phacoemulsification of both eyes performed at different intervals between the operations: 1–5 days — 22 patients (44 eyes), 1–3 weeks — 31 patients (62 eyes), 4 or more weeks — 40 patients (80 eyes). Before surgery, visual acuity of the first eye was, on average, 0.38 ± 0.05, while that of the second eye averaged 0.41 ± 0.05. The operations were performed on the «Infiniti Vision System» (Alcon) phacoemulsifier by Ozil technology through a corneal tunnel 2.2 mm long by one and the same surgeon with no complications. The Phaco chop technique was used. All patients underwent retinal examination by Optovue Avante OPT (OPTOVUE, USA) according to the scanning Protocol Raster and, partly, by Retina map (including central retinal thickness and volume of the macula in the 5 mm zone) before the operation, and 1, 2, 4, 12 weeks after surgery, on both eyes. Results. Before surgery, the average central retinal thickness and the volume of the retina in the area of 5 mm, in both operated eyes were almost identical: the first eye revealed 271.0 ± 7.5 μm, and 5.625 ± 0.040 mm3, the second one revealed 270.0 ± 8.5 μm, and 5.628 ± 0.040 mm3. In the postoperative period, the results showed no statistically significant differences (p > 0.05) between the central retinal thickness and volume in the 5 mm zone before and after surgery in both eyes, regardless of the intervals between operations. Conclusion. The absence of a significant difference in the macular retina response to surgery, confirmed by OCT data, indicated the safety of operations on both eyes regardless of the intervals between them.

Effect of Axial Length on Full-Field and Multifocal Electroretinogram

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Noura S Hamzawy ◽  
Tarek A El-Zarakany ◽  
Amany A El-Shazly ◽  
Sameh H Mohamed
Keyword(s):  
Visual Acuity ◽  
Negative Correlation ◽  
Axial Length ◽  
Multifocal Electroretinogram ◽  
Case Series ◽  
Length Measurement ◽  
Peripheral Retina ◽  
Full Field ◽  
Case Series Study ◽  
Four Quadrant

Abstract Background The Electroretinogram is a mass potential, which reflects the summed electrical activity of the retina. Full-field ERG measures the electrical signals from the whole retina in response to a light stimulus. The weakness of the full-field ERG is that it cannot provide topographical information regarding the functional integrity of the retina and cannot detect subtle functional defects. The response is dominated by the peripheral retina due to its predominance of retinal cells. Aim of the Work to investigate the effect of axial length on fullfield (ffERG)and multifocal ERG (mfERG). Subjects and Methods Forty-four eyes of 44 healthy subjects were included in this case series study which has been conducted at Ain shams university hospitals after the approval of the research ethical committee in the faculty of medicine, Ain Shams University between July 2018 and September 2019. Full ophthalmologic examination was performed for all participants, including visual acuity assessment (Best corrected visual acuity) using Snellen chart, calculation of spherical equivalent (SE), slit Lamp biomicroscopy examination with IOP measurement via Goldmann applanation tonometry (GAT), and fundus examination by indirect ophthalmoscope or via 90 D VOLK lens to assess macular area. Axial length measurement, ffERG & mf-ERG. Results; We found that in the absence of fundus changes, mfERG parameters showed decreased amplitudes with increase in axial length. The Six- Rings Response Densities showed negative correlation with AL while there is no significant correlation between Six- Rings Response Densities and SE. The Six- Rings P1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The Six- Rings N1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The four- quadrant Response Densities showed negative correlation with AL while there is no significant correlation between four- quadrant Response Densities and SE. The four- quadrant P1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The four- quadrant N1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. There is no significant correlation between full-field clinical ERG parameters and both AL and SE. Conclusion In the absence of fundus changes, mfERG parameters showed decreased amplitudes with increase in axial length. For correct interpretation of ERG responses in clinical practice, we recommend consideration of axial length measurement when evaluating mfERG responses.

scholarly journals The pathogenetic substantiation of the use of angiotensin-converting enzyme for the treatment of diabetic retinopathy

2012 ◽  
Vol 58 (5) ◽  
pp. 37-40
Author(s):  
M V Riabina ◽  
N B Chesnokova ◽  
T D Okhotsimskaia ◽  
T P Kuznetsova
Keyword(s):  
Diabetic Retinopathy ◽  
Ace Inhibitor ◽  
Retinal Thickness ◽  
Glycosylated Hemoglobin ◽  
Diabetic Macular Oedema ◽  
Renin Angiotensin System ◽  
Retinal Ischemia ◽  
Angiotensin System ◽  
Before And After ◽  
Ace Activity

The objective of the present work was to study visual functions, as well as changes in the systemic and local renin-angiotensin system before and after intake of the ACE inhibitor perindopril in 65 patients (130 eyes) presenting with diabetic retinopathy. The treatment caused the most pronounced changes in the patients with preproliferative diabetic retinopathy including the two-fold (p<0.05) decrease of ACE activity in the blood and its 7.5-fold (p<0.05) increase in the tears. These effects appear to be attributable to the action of perindopril on the levels of the proangiogenic factors known to be elevated in the patients with severe retinal ischemia. The treatment of patients with diabetic macular oedema with perindopril resulted in the decrease of the retinal thickness from 392.5±46.7 to 347.2±39.6 mcm in the absence of significant improvement in the acuteness of vision. All the patients experienced a significant reduction in the level of glycosylated hemoglobin.

scholarly journals A Retrospective Analysis of the Results of Microinvasive Posterior Vitrectomy in the Surgical Treatment of Non-Full Thickness Macular Holes

2018 ◽  
Vol 15 (2S) ◽  
pp. 239-245 ◽  
Author(s):  
Y. V. Bayborodov ◽  
K. S. Zhogolev ◽  
L. I. Balashevich ◽  
I. E. Panova ◽  
D. R. Mirsaitova
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Retinal Thickness ◽  
Maximum Diameter ◽  
Full Thickness ◽  
Ellipsoid Zone ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Before And After

Purpose:to study the effectiveness of the posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes on the basis of the retrospective analysis of the retina changes, identified by OCT, and functional outcomes of surgical treatment.Patients and Methods. A retrospective analysis of outcomes of posterior microinvasive vitrectomy was performed in 30 patients operated about non-full thickness macular holes. The following features were assessed: maximum diameter of the non-full thickness macular holes, the diameter at the base of the hole, the minimum thickness of the retina before and after operation, the maximum thickness of the retina before and after surgery. In addition, the configuration of the hole edges before surgery, the presence of intraretinal cysts before and after surgery, the integrity of the ellipsoid zone of the photoreceptors before and after the operation and the restoration of fovea centralis as a result of surgical treatment were assessed.Results. As a result of surgical treatment the closure of non-full thickness macular holes was reached in all cases. The most corrected visual acuity in the postoperative period was ranged from 0.1 to 1.0 (0,66 ± 0,04). The visual acuity improved in 20 cases (64.5%), remained at the same level in 8 cases (25.8%) and decreased in 3 cases (9.6%, in 1 case due to the development of cataracts). The results of correlation analysis has allowed to establish correlation between the initial BCVA and the maximum retinal thickness (R = –0.4), and residual retinal thickness in the area of the hole (R = –0.3). The increase in visual acuity after surgical treatment significantly affected the recovery of the ellipsoid zone of the photoreceptors (RD = 0.833), regression of the retinal thickness (R = 0.42). In addition, the initial diameter of non-full thickness macular holes, both external and at the base, also had an impact on the increase in BCVA (R = –0.3 and R = –0.25, respectively).Conclusion. Posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes is a highly effective method of treatment, as evidenced by the closure of the defect and improvement or stabilization of the most corrected visual acuity 90.4% cases. On the basis of the retrospective analysis it is found that the most significant increase in the most corrected visual acuity was increased in patients with low visual acuity. The recovery of the ellipsoid zone of photoreceptors, regression of the retinal thickness and the diameter of non-full thickness macular holes, both external and at the base mostly influences nn the recovery of the most corrected visual acuity. 

scholarly journals Multifocal Electroretinogram in Hydroxychloroquine-related Macular Toxicity

1970 ◽  
Vol 12 (4) ◽  
pp. 224-228
Author(s):  
Parveen Sen ◽  
Priya Ravi ◽  
Rupak Roy
Keyword(s):  
Rheumatoid Arthritis ◽  
Visual Acuity ◽  
Colour Vision ◽  
Multifocal Electroretinogram ◽  
Retinal Toxicity ◽  
The Other ◽  
Automated Perimetry ◽  
Full Field

Prolonged use of hydroxychloroquine is common in patients with rheumatoid arthritis. Retinal toxicity due to hydroxychloroquine is known, and is monitored by investigations such as visual acuity, Amsler chart, colour vision, automated perimetry, full-field electroretinogram, and electrooculogram. Multifocal electroretinogram can suggest macular toxicity due to hydroxychloroquine even when the other investigations have normal results. Hence, multifocal electroretinogram has a role in the screening and follow-up of patients with suspected hydroxychloroquine toxicity.

scholarly journals Effect of smoking on macular function and retinal structure in retinitis pigmentosa

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Akio Oishi ◽  
Kazunori Noda ◽  
Johannes Birtel ◽  
Masahiro Miyake ◽  
Atsuyasu Sato ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Smoking History ◽  
Macular Function ◽  
Ellipsoid Zone ◽  
Zone Width ◽  
Age And Sex

Abstract Retinitis pigmentosa is an inherited neurodegenerative disease of the retina. We investigated smoking as a modifiable environmental factor for the progression of this currently untreatable disease. Clinical data, smoking history, macular function and morphology including visual acuity, visual field sensitivity, ellipsoid zone width and central retinal thickness were investigated. Association between pack × years and these parameters were evaluated using generalized estimating equation models to adjust confounding factors such as age and sex. A total of 410 patients with retinitis pigmentosa (≥20 years old; 209 female) were included, 164 had a smoking history. Patients without smoking history revealed a better visual acuity than smokers (0.39 versus 0.57, P = 0.001). The pack × years index was associated with worse visual acuity and thinner central retinal thickness after adjusting for age and sex (P = 0.0047 and 0.0099, respectively). Visual field and ellipsoid zone width showed a non-significant decline with increasing pack × years. This study indicates an association of smoking with worse macular function and structural integrity in retinitis pigmentosa patients, and hence a potential detrimental effect of smoking on the disease course.

scholarly journals Cone Dystrophies: An Optical Coherence Tomography Angiography Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1500
Author(s):  
Lisa Toto ◽  
Maurizio Battaglia Parodi ◽  
Rossella D’Aloisio ◽  
Stefano Mercuri ◽  
Alfonso Senatore ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Thickness ◽  
Multifocal Electroretinogram ◽  
Vessel Density ◽  
Field Pattern ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Macular Function ◽  
Capillary Plexus

Background: This study investigates the relationship between retinal vascularization and macular function in patients with cone dystrophies (CDs). Methods: Twenty CD patients (40 eyes) and 20 healthy controls (20 eyes) were enrolled in this prospective case-control study. Patients underwent full ophthalmological examination, microperimetry, full-field, pattern and multifocal electroretinogram (ERG, PERG, mfERG) and optical coherence tomography angiography (OCTA). Main outcome measures were as follows: foveal and parafoveal inner and outer retinal thickness; microperimetry sensitivity in the central 4° and 8°, ERG b wave amplitudes and peak times, PERG P50 and N95 amplitudes and latencies, and mfERG N1 to P1 amplitudes; and superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillary (CC) plexus vessel densities, divided into foveal and parafoveal region. Results: Retinal thickness, SCP and DCP densities were significantly related to PERG. A significant relationship was found between foveal and parafoveal retinal thicknesses and foveal SCP density (p < 0.001 and p = 0.018, respectively) and between parafoveal retinal thickness and parafoveal SCP density (p = 0.002). Foveal and parafoveal retinal thicknesses were significantly related to parafoveal DCP density (p = 0.007 and p < 0.001). Foveal and parafoveal retinal thicknesses, foveal SCP and parafoveal DPC densities were significantly reduced in CD patients compared to controls (p < 0.001; p = 0.010 and p = 0.008, respectively). PERG and mfERG amplitudes were significantly reduced in CD patients compared to controls (p < 0.01). Conclusions: CD eyes showed reduced retinal thickness significantly related to reduced vessel density, possibly caused by a decreased metabolic demand. In addition, vessel density significantly correlated with loss of function.

scholarly journals Electrophysiology as a prognostic indicator of visual recovery in diabetic patients undergoing cataract surgery

2021 ◽  
Author(s):  
Hao Wang ◽  
Fuliang Li ◽  
Jiawen Li ◽  
Jun Lin ◽  
Meifang Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Prognostic Indicator ◽  
Oscillatory Potentials ◽  
Diabetic Control ◽  
Diabetic Patients ◽  
Visual Recovery ◽  
Full Field ◽  
Significant Difference ◽  
Visual Acuity Loss

Abstract Purpose Visual outcomes after cataract surgery in diabetic patients with retinal or visual pathway disease are difficult to predict as the fundus may be obscured, and assessment of visual potential is challenging. This study assessed the value of visual electrophysiology as a prognostic indicator of visual recovery in diabetic patients with cataract, prior to cataract surgery. Methods Forty-one diabetic patients (aged 52–80; 74 eyes) and 13 age-matched non-diabetic control patients (21 eyes) were examined prior to cataract surgery. Pre-surgical examinations included best-corrected visual acuity (BCVA), slit-lamp bio-microscopy, ISCEV-standard full-field electroretinography (ffERG), and flash visual evoked potential (flash VEP) testing. Electrophysiological assessments included quantification of the DA and LA ERG, oscillatory potentials (OPs; OP1, OP2, OP3, OP4) and flash VEP P1, P2, and P3 components. Post-operative BCVA was measured in all cases and the diabetic patients grouped according to the severity of visual acuity loss: mild (logMAR ≤ 0.1), moderate (0.1 < logMAR < 0.5), or severe (logMAR ≥ 0.5). A fourth group included those without diabetes. The pre-surgical electrophysiological data was compared between the four groups by analysis of variance. Results The severity of post-surgical visual acuity loss in the diabetic patients was classified as mild (N=22 eyes), moderate (N=31 eyes), or severe (N=21 eyes). In the group without diabetes, post-surgical visual impairment was classified as mild (N=21 eyes). The pre-operative DA 10.0 ERG a-wave amplitudes, DA 3.0 ERG OP2 amplitudes, and the LA 3.0 a- and b-wave amplitudes showed best significant differences among the four groups. The flash VEP did not show significant difference between groups. Conclusion Electrophysiological assessment of diabetic patients with cataract can provide a useful measure of retinal function. Full-field ERG components, including the DA 10.0 ERG a-wave, DA 3.0 ERG OP2 component, and the LA 3.0 a- and b-wave amplitudes, are of prognostic value in predicting post-surgical visual acuity, and may inform the surgical management of cataract patients with diabetes.

Sign in / Sign up

Export Citation Format

Share Document