Changes of focal macular and full-field electroretinograms after intravitreal aflibercept in patients with central retin
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ORIGINAL RESEARCH ARTICLE
Changes of focal macular and full-field electroretinograms after intravitreal aflibercept in patients with central retinal vein occlusion Tomoharu Nishimura . Shigeki Machida
. Yuji Hara
Received: 5 September 2019 / Accepted: 17 March 2020 Ó Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the physiology of the macular and whole retina after intravitreal aflibercept (IVAs) injections in patients with macular edema associated with a central retinal vein occlusion (CRVO) by electroretinography (ERG). Methods We studied 20 eyes of 20 patients with nonischemic CRVO (72.0 ± 9.2 years). All patients were treated with monthly injections of IVA for the initial 3 months and then treated by the treat-and-extend (TAE) regimen for 12 months. The best-corrected visual acuity (BCVA), optical coherence tomographic images, focal macular ERGs (fmERGs), and full-field ERGs recorded before and after the treatment were compared. The fmERGs were elicited by a 15° white stimulus spot centered on the fovea. The full-field ERGs were recorded by a protocol recommended by International Society for Clinical Electrophysiology of Vision. The amplitudes and implicit times determined before and after the IVA were compared. Results The foveal thickness was significantly reduced accompanied by improvement of the BCVA after the treatments, and the improvements were maintained for at least 12 months. The amplitudes and implicit times of the fmERGs improved
T. Nishimura S. Machida (&) Y. Hara Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, 2-1-50 MinamiKoshigaya Koshigaya, Saitama 343-8555, Japan e-mail: [email protected]
continuously for the 12 months. On the other hand, the reduced amplitudes of the full-field ERG, summed oscillatory potentials, and the photopic negative responses remained unchanged for the 12-month period. However, the implicit times of the maximum and cone responses were significantly shortened after the IVA. Conclusions IVA injections by the TAE regimen led to a continuous improvement of the macular function in patients with ME associated with a CRVO. However, the function of the whole retina changed differently than the macula after the treatment. Keywords Central retinal vein occlusion Focal macular ERG Full-field ERG Aflibercept Treatand-extend
Introduction A central retinal vein occlusion (CRVO) is a vascular disorder which affects approximately 0.3% of the Japanese population over the age of 40 years [1]. The visual prognosis and treatment protocol depend on whether it is the ischemic or non-ischemic type of CRVO. Because a transition from the non-ischemic type to the ischemic type often occurs [2], careful observations of the hemodynamics are required.
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The macular edema (ME) associated with a CRVO is the major cause of the decreased vision, and it is associated with a poor visual prognosis. Because the ME frequently causes irreversibl
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