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Impressum
Assessment of central retinal function by multifocal electroretinography before and after treatment of subretinal neovascularisation by photodynamic therapy
Breidenbach K., Rüther K., Schwartz R., Hassenstein A., Richard G.
University Eye Hospital Hamburg
Purpose: Photodynamic therapy (PDT) with Verteporfin has shown
to have a beneficial effect on the progress of visual deterioration in
patients with choroidal neovascularisation. Central retinal function was
assessed by multifocal electroretinography (mf-ERG) before and after treatment
with PDT.
Methods: 10 patients suffering in one eye from classic or predominantly
classic (>50%) choroidal neovascularisation due to age related macular
degeneration were examined by mf-ERG (RETIscan) before and 7,5 (median)
weeks after PDT. Visual acuity was 0.1 or better. The central 30°
of the retina were stimulated by 61 hexagones of the mf-ERG. They were
grouped in one central field and two peripheral rings. The normalised
amplitudes per area of the main positive deflection and its implicit time
were analysed.
Results: In 7 of 10 eyes the choroidal neovascular membrane was
smaller than the central field of 10° stimulated by the mf-ERG. The
size of the laserspot was corresponding to the size of the membrane plus
an additional 1000µ safety margin. This resulted in a spot size
which also covered the first peripheral ring in 8 of 10 patients. Regarding
the central field 5 of 10 eyes showed an increased, 5 a reduced amplitude
after PDT, 4 eyes showed a prolonged, one an unchanged and 5 eyes a shorter
implicit time. After PDT treatment the amplitude of the mf-ERG showed
a decrease to 97% in the central region and an increase of amplitude in
the two peripheral rings up to 104% and 103%. The implicit time remained
nearly unchanged in the central region (99%) and was slightly prolonged
in the two peripheral rings (102%). All changes observed were not statistically
significant (ANOVA, 5%).
Conclusion: Using multifocal ERG no statistically significant effect
of PDT treatment on the central retinal function could be detected.