Monitoring Retinal Function during Transpupillary Thermotherapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Falsini, Benedetto; Focosi, F.; Molle, Fernando; Manganelli, Chiara; Iarossi, Giancarlo; Fadda, Antonello; Dorin, Giorgio; Mainster, Martin A.

doi:10.1167/iovs.02-0716

Cited by 13 publications

(13 citation statements)

References 48 publications

(53 reference statements)

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“…They based their method on the subjective functional findings of Mayer and associates, 47 who found that affected low and midtemporal frequencies were associated with funduscopic features in early ARM. In addition, the focal ERG has been successfully applied to document effects of treatment after transpupillary thermotherapy in occult neovascular ARM 48 and after short term antioxidant supplementation in subjects with early ARM. 49 While the focal ERG is useful in documenting age-related maculopathy, the application is restricted to one area and it does not allow a mapping of many areas within the posterior pole.…”

Section: Full-field and Focal Electrophysiological Assessment In Armmentioning

confidence: 99%

Objective functional assessment of age‐related maculopathy: a special application for the multifocal electroretinogram

Feigl

Lovie‐Kitchin

Brown

2005

Clinical and Experimental Optometry

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This paper gives a brief review of methods that assess objectively function in age-related maculopathy (ARM) with emphasis on a newer method, the multifocal electroretinogram (mfERG). In contrast to other electrophysiological tests, such as the full-field and focal electroretinogram (ERG) or the electro-oculogram (EOG), which measure summed responses from various cells from larger areas of the retina, the multifocal electroretinogram maps function locally with a resolution as small as four degrees within the central 30 degrees. By using different paradigms it can measure local cone- and rod-mediated functional impairment at early and late stages of ARM. This improved mapping and higher resolution of the posterior pole compared to other objective methods might lead to earlier detection of ARM. Its usefulness has been demonstrated in documenting the effects of treatment after established laser treatments, such as photodynamic therapy (PDT) and in documenting function after retinal pigment epithelial transplantation, a possible future treatment in late neovascular ARM.

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Section: Full-field and Focal Electrophysiological Assessment In Armmentioning

confidence: 99%

Objective functional assessment of age‐related maculopathy: a special application for the multifocal electroretinogram

Feigl

Lovie‐Kitchin

Brown

2005

Clinical and Experimental Optometry

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“…However, the higher temperature will also spread to the sensory retina and induce damage leading to a decrease in the FMERGs. An earlier study reported that the amplitudes of the focal ERGs decreased transiently after TTT in spite of the absence of ophthalmoscopic changes of the fundus [21]. However, the impairment of retinal function is temporary, and longer follow-up studies at 3 and 6 months are necessary to determine the final effect of TTT on the focal ERGs.…”

Section: Discussionmentioning

confidence: 98%

Changes in Foveal Thickness and Macular Function after Transpupillary Thermotherapy for Age-Related Macular Degeneration

et al. 2005

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Purpose: To evaluate the effect of transpupillary thermotherapy (TTT) on foveal thickness and macular function in eyes with choroidal neovascularization (CNV) associated with age-related macular degeneration. Methods: Sixteen eyes with occult CNV and 6 eyes with classic CNV were treated with TTT. Optical coherence tomography and focal macular electroretinograms (FMERGs) elicited by a 15-degree stimulus were performed before, 3 months after TTT in 22 eyes and 6 months after TTT in 18 eyes. Results: Before TTT, the fovea in 20 of the 22 eyes with CNV was significantly thicker than that of normal subjects. The foveal thickness was reduced after TTT in 11 of 14 eyes with occult CNV and remained unchanged in 2 eyes. One eye with occult CNV before TTT developed a classic CNV with significant macular edema and increased foveal thickness 3 months after TTT. The amplitudes of the FMERGs were reduced in all eyes before TTT. In eyes with occult CNV, the mean b-wave amplitude increased significantly after TTT (p = 0.0260 at 3 months, p = 0.0142 at 6 months). When the change of foveal thickness was less than 20% after TTT, all eyes with occult CNV had a 30% or more increase in the b-wave amplitude. In eyes with classic CNV, the mean amplitude of the a- and b-waves did not change significantly after TTT. Conclusions: TTT improves macular function in eyes with occult CNV associated with age-related macular degeneration more when the change of foveal thickness is slight.

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“…Treatment was performed with one spot of 60 seconds duration at a variable power setting of 400−600 mW, such that no visible change of the lesion was detected throughout the treatment. The choice of power setting for an individual eye was based on a combination of parameters, including VA, and iris and fundus pigmentation, according to a published protocol (Falsini et al 2003).…”

Section: Methodsmentioning

confidence: 99%

“…Possible mechanisms include thermally induced changes in ocular blood flow, selective damage to endothelial cells of abnormal choroidal new vessels through hyperexpression of heat shock proteins, and subthreshold activation of RPE cells (Samali & Orrhenius 1988; Beckmann et al 1990; Mainster & Reichel 2000; Ciulla et al 2001; Desmettre et al 2001). The effects of TTT on retinal function are a matter of investigation (Falsini et al 2003). While some studies suggest an efficacy of treatment on CNV, it is still unknown whether, and to what extent, the neurosensory retina undergoes changes as a result of TTT.…”

Section: Introductionmentioning

confidence: 99%

Retinal function following transpupillary thermotherapy for occult choroidal neovascularization in age‐related macular degeneration: a short‐term study by focal electroretinography

Pirozzi

Manganelli

Piccardi

et al. 2005

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To assess short-term changes in macular function after transpupillary thermotherapy (TTT) in patients with occult subfoveal choroidal neovascularization (CNV) secondary to agerelated macular degeneration (AMD), using focal electroretinography (FERG).Methods: Twenty-five patients with occult subfoveal CNV due to AMD were treated with TTT delivered using an infrared (810 nm) diode laser (spot size 3.0 mm, laser power 400-600 mW, duration 60 seconds). All patients were clinically evaluated before, 1 and 6 weeks after treatment. Snellen visual acuity (VA) was measured at each visit. Fluorescein angiography (FA) was performed at baseline and 6 weeks after TTT. Focal ERGs were recorded in all patients immediately before and 1 week after TTT in response to an 18-degree diameter, 41 Hz flickering spot (630 nm) centred on the fovea, presented on a steady background in Maxwellian view. A subgroup of 12 patients was also re-tested by FERG at 6-weeks post-TTT.Results: No significant changes in mean FERG amplitude and phase were observed across the different recording sessions before and after TTT. One week after TTT, four patients had significant (>2 SD from baseline variability) increases in FERG amplitude and/or phase advances, one had a decrease in amplitude and four had phase delays, compared to baseline. The remaining 15 patients had stable FERGs. Six weeks after TTT, four patients had significant increases in FERG amplitude and/or phase advances, four had decreases in amplitude and/or phase delays, and four had stable FERGs, compared to baseline. Improvement in FERG parameters after TTT was always associated with an improvement in VA and a decrease in exudation. Patients with post-TTT FERG deterioration had stable or deteriorated clinical pictures. At either 1 or 6 weeks post-TTT, the FERG amplitude increase was inversely correlated (p < 0.05) with the baseline FERG amplitude and VA.Conclusions: Three major conclusions can be drawn: in a short-term follow-up, TTT was not found to be associated with significant changes in macular function; FERG improvement was associated with VA improvement, and the increase in FERG amplitude was greatest in patients with the worst baseline acuity.

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Monitoring Retinal Function during Transpupillary Thermotherapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Cited by 13 publications

References 48 publications

Objective functional assessment of age‐related maculopathy: a special application for the multifocal electroretinogram

Objective functional assessment of age‐related maculopathy: a special application for the multifocal electroretinogram

Changes in Foveal Thickness and Macular Function after Transpupillary Thermotherapy for Age-Related Macular Degeneration

Retinal function following transpupillary thermotherapy for occult choroidal neovascularization in age‐related macular degeneration: a short‐term study by focal electroretinography

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