Peripheral retinal function assessed with 30-Hz flicker seems to improve after treatment with Lucentis in patients with diabetic macular oedema

Holm, Karolina; Schroeder, Marion; Adrian, Monica Lövestam

doi:10.1007/s10633-015-9495-9

Cited by 23 publications

(22 citation statements)

References 25 publications

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“…The amplitudes of the flicker ERGs were not significantly different at the different phases in both eyes and all the subgroups classified by the injected agent or the disease. This is consistent with previous studies [21][22][23]. However, this lack of significant differences in the amplitudes of the flicker ERGs may be due to the relatively large variations in the amplitudes of the flicker ERGs.…”

Section: Discussionsupporting

confidence: 93%

“…However, they did not compare the implicit times of the non-injected fellow eyes before and after the injection of ranibizumab into the affected eye. Holm et al reported that the implicit time of the 30 Hz flicker full-field ERGs were significantly shorter at 4 weeks after the third monthly injection anti-VEGF agents in eyes with DME [22]. Gabriel et la reported that the implicit times and the amplitudes of all components of the full-field ERGs were not significantly different at 12 and 24 weeks after the intravitreal injection of ziv-aflibercept in eyes with diabetic retinopathy [23].…”

Section: Discussionmentioning

confidence: 99%

“…Retinal functions can be evaluated by electroretinography (ERG) and can be performed not only by the conventional ERG systems [21][22][23] but also by a new RETeval system. This RETeval system consists of a handheld, portable ERG device that includes stimulating and recording elements [21,24,25].…”

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confidence: 99%

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Retinal Function determined by Flicker ERGs before and soon after Intravitreal Injection of Anti-VEGF Agents

Terauchi

Shinoda²,

Sakai

et al. 2019

Preprint

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Background: To evaluate the retinal function before and soon after an intravitreal injection of an anti-vascular endothelial growth factor (anti-VEGF) agents. Methods: Seventy-nine eyes of 79 patients that were treated by an intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion (RVO) with macular edema (ME) were studied. The RETeval® system was used to record 28 Hz flicker electroretinograms (ERGs) from the injected and non-injected eyes before (Phase 1, P1), within 2 hours after the injection (P2), and 2 to 24 hours after the injection (P3). Patients were grouped by disease or by the injected agent and compared. The significance of the changes in the implicit times and amplitudes was determined by t tests. Results: The amplitudes were not significantly different at the three phases. The implicit time of the injected eye was 31.2±3.2 msec at P1, and it was not significantly different at P2 (31.7±3.1 msec) but it was significantly longer at P3 (32.2±3.3 msec, P<0.01, ANOVA for both). The implicit time in the non-injected fellow eye was 30.5±3.3 msec at P1, and it was significantly longer at P2 (31.1±3.2 msec) and phase 3 (31.3±3.4 msec, P<0.01, ANOVA for both). Conclusions: The results indicate that an intravitreal anti-VEGF injection will increase the implicit times not only in the injected eye but also in the non-injected eye soon after the intravitreal injection.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Retinal Function determined by Flicker ERGs before and soon after Intravitreal Injection of Anti-VEGF Agents

Terauchi

Shinoda²,

Sakai

et al. 2019

Preprint

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“…Visual fields are highly correlated with ETDRS Classification [28] of severity of retinopathy. Flicker ERG [35], color vision [36, 37], and contrast sensitivity [37] are all functionally impaired in diabetic retinopathy likely due to retinal ischemia. For these visual characteristics what we know is only the statement about the properties of diabetics' vision in general but we lack visual function parameters, such as visual thresholds, flicker fusion frequency, or color vision for local ischemic versus nonischemic areas of the diabetic peripheral retina except for the data of Chee and Flanagan (1993) [38].…”

Section: Discussionmentioning

confidence: 99%

A Computational Model of Peripheral Photocoagulation for the Prevention of Progressive Diabetic Capillary Occlusion

Gast

Gens

et al. 2016

Journal of Diabetes Research

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We developed a computational model of the propagation of retinal ischemia in diabetic retinopathy and analyzed the consequences of various patterns and sizes of burns in peripheral retinal photocoagulation. The model addresses retinal ischemia as a phenomenon of adverse local feedback in which once a capillary is occluded there is an elevated probability of occlusion of adjacent capillaries resulting in enlarging areas of retinal ischemia as is commonly seen clinically. Retinal burns of different sizes and patterns, treated as local oxygen sources, are predicted to have different effects on the propagation of retinal ischemia. The patterns of retinal burns are optimized with regard to minimization of the sum of the photocoagulated retina and computer predicted ischemic retina. Our simulations show that certain patterns of retinal burns are effective at preventing the spatial spread of ischemia by creating oxygenated boundaries across which the ischemia does not propagate. This model makes no statement about current PRP treatment of avascular peripheral retina and notes that the usual spot sizes used in PRP will not prevent ischemic propagation in still vascularized retinal areas. The model seems to show that a properly patterned laser treatment of still vascularized peripheral retina may be able to prevent or at least constrain the propagation of diabetic retinal ischemia in those retinal areas with intact capillaries.

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“…246 Functional testing of macular sensitivity utilizing microperimetry and electroretinography is also being increasingly used in both DR and DME to assess both disease severity and response to therapy. [247][248][249][250][251][252][253][254][255][256][257][258][259][260][261][262] These provide new indices to explore, seeking prognostic value for response to therapy. In light of recent data demonstrating the incomplete correlation of VA and macular thickness on OCT imaging, non-anatomic diagnostics of macular function will play an increasing role in management of DME.…”

Section: Future Trends Diagnosticsmentioning

confidence: 99%

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Mansour¹,

Browning²,

Wong³

et al. 2020

OPTH

177

119

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Purpose: To review the current therapeutic options for the management of diabetic retinopathy (DR) and diabetic macular edema (DME) and examine the evidence for integration of laser and pharmacotherapy. Methods: A review of the PubMed database was performed using the search terms diabetic retinopathy, diabetic macular edema, neovascularization, laser photocoagulation, intravitreal injection, vascular endothelial growth factor (VEGF), vitrectomy, pars plana vitreous surgery, antiangiogenic therapy. With additional cross-referencing, this yielded 835 publications of which 301 were selected based on content and relevance. Results: Many recent studies have evaluated the pharmacological, laser and surgical therapeutic strategies for the treatment and prevention of DR and DME. Several newer diagnostic systems such as optical coherence tomography (OCT), microperimetry, and multifocal electroretinography (mfERG) are also assisting in further refinements in the staging and classification of DR and DME. Pharmacological therapies for both DR and DME include both systemic and ocular agents. Systemic agents that promote intensive glycemic control, control of dyslipidemia and antagonists of the renin-angiotensin system demonstrate beneficial effects for both DR and DME. Ocular therapies include anti-VEGF agents, corticosteroids and nonsteroidal anti-inflammatory drugs. Laser therapy, both as panretinal and focal or grid applications continue to be employed in management of DR and DME. Refinements in laser devices have yielded more tissue-sparing (subthreshold) modes in which many of the benefits of conventional continuous wave (CW) lasers can be obtained without the adverse side effects. Recent attempts to lessen the burden of anti-VEGF injections by integrating laser therapy have met with mixed results. Increasingly, vitreoretinal surgical techniques are employed for less advanced stages of DR and DME. The development and use of smaller gauge instrumentation and advanced anesthesia agents have been associated with a trend toward earlier surgical intervention for diabetic retinopathy. Several novel drug delivery strategies are currently being examined with the goal of decreasing the therapeutic burden of monthly intravitreal injections. These fall into one of the five categories: non-biodegradable polymeric drug delivery systems, biodegradable polymeric drug delivery systems, nanoparticle-based drug delivery systems, ocular injection devices and with sustained release refillable devices. At present, there remains no one single strategy for the management of the particular stages of DR and DME as there are many options that have not been rigorously tested through large, randomized, controlled clinical trials. Conclusion: Pharmacotherapy, both ocular and systemic, will be the primary mode of intervention in the management of DR and DME in many cases when cost and treatment burden are less constrained. Conventional laser therapy has become a secondary intervention in these instances, but remains a first-line option when cost and ...

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Peripheral retinal function assessed with 30-Hz flicker seems to improve after treatment with Lucentis in patients with diabetic macular oedema

Cited by 23 publications

References 25 publications

Retinal Function determined by Flicker ERGs before and soon after Intravitreal Injection of Anti-VEGF Agents

Retinal Function determined by Flicker ERGs before and soon after Intravitreal Injection of Anti-VEGF Agents

A Computational Model of Peripheral Photocoagulation for the Prevention of Progressive Diabetic Capillary Occlusion

<p>The Evolving Treatment of Diabetic Retinopathy</p>

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