RESUMEN
PURPOSE: To assess the value of multifocal electroretinogram (mfERG) in clinical evaluation of the response of patients with choroidal neovascularization (CNV), secondary to age-related macular degeneration, to photodynamic therapy (PDT). METHODS: We designed a prospective non-comparative case series and enrolled 23 eyes of 22 patients with predominantly classic CNV. The initial evaluation included clinical examination with measurement of visual acuity (Colenbrander), biomicroscopic evaluation (BMC), retinography, fluorescein angiography (FA), Humphrey 24-2 visual field examination and mfERG. All patients were treated with PDT. Clinical follow-up was performed two and six months after treatment with visual acuity evaluation, BMC, visual field assessment and mfERG. FA was repeated after an interval of between four and six months in all patients. RESULTS: Visual acuity remained stable or improved in all patients included in the study. Visual field examination gave erratic and unreliable results because of patients' unstable fixation. N1 and P1 wave peak amplitudes in the central rings did not change significantly after treatment but they improved in rings 3 (p=0.000), 4 and 5 (p=0.008). CONCLUSIONS: Multifocal ERG is a useful tool for the clinical follow-up of CNV. It offers interesting non-subjective data of retinal sensitivity of patients with macular diseases treated with PDT. In addition we obtained a central retinal sensitivity map where we were able to evaluate the extent and depth of retinal damage.
Asunto(s)
Neovascularización Coroidal/diagnóstico , Electrorretinografía , Degeneración Macular/diagnóstico , Neovascularización Coroidal/tratamiento farmacológico , Femenino , Humanos , Degeneración Macular/tratamiento farmacológico , Masculino , Fotoquimioterapia/métodos , Estudios Prospectivos , Agudeza VisualRESUMEN
Objetivo: Determinar la utilidad del electrorretinograma multifocal (mfERG) en la evaluación clínica de la respuesta al tratamiento con terapia fotodinámica (TFD) en pacientes con neovascularización coroidea (NVC) secundaria a degeneración macular asociada a la edad (DMAE).Métodos: Se ha realizado un estudio prospectivo en 23 ojos de 22 pacientes con NVC predominantemente clásica. Al inicio se realizó una medición de la agudeza visual mediante optotipos de Colenbrander, exploración biomicroscópica (BMC), retinografía, angiografía fluoresceínica (AGF), campimetría de Humphrey 24-2 y mfERG. Todos los pacientes fueron tratados mediante TFD. Se ha repetido la exploración de la agudeza visual, BMC, campimetría y mfERG a los dos y a los seis meses del tratamiento y se ha realizado una AGF tras un intervalo entre los cuatro y seis meses del inicio del estudio.Resultados: La agudeza visual permanece estable o mejora en todos los pacientes incluidos en el estudio. El estudio campimétrico nos ofrece resultados erráticos y poco fiables debido a la mala fijación que presentan estos pacientes. La densidad de respuesta de las ondas N1 y P1 del mfERG en los anillos centrales no muestra variaciones significativas después del tratamiento, sin embargo mejora en los anillos 3 (p=0,000), 4 y 5 (p=0,008).Conclusiones: El mfERG es una prueba de utilidad en el seguimiento de la NVC puesto que nos permite medir objetivamente la sensibilidad retiniana en pacientes con maculopatías tratadas con terapia fotodinámica. Por otra parte obtenemos un mapa de sensibilidades de la retina central en el que podemos valorar la extensión y la profundidad de la lesión
Purpose: To assess the value of multifocal electroretinogram (mfERG) in clinical evaluation of the response of patients with choroidal neovascularization (CNV), secondary to age-related macular degeneration, to photodynamic therapy (PDT) Methods: We designed a prospective non-comparative case series and enrolled 23 eyes of 22 patients with predominantly classic CNV. The initial evaluation included clinical examination with measurement of visual acuity (Colenbrander), biomicroscopic evaluation (BMC), retinography, fluorescein angiography (FA), Humphrey 24-2 visual field examination and mfERG. All patients were treated with PDT. Clinical follow-up was performed two and six months after treatment with visual acuity evaluation, BMC, visual field assessment and mfERG. FA was repeated after an interval of between four and six months in all patients. Results: Visual acuity remained stable or improved in all patients included in the study. Visual field examination gave erratic and unreliable results because of patients unstable fixation. N1 and P1 wave peak amplitudes in the central rings did not change significantly after treatment but they improved in rings 3 (p=0.000), 4 and 5 (p=0.008). Conclusions: Multifocal ERG is a useful tool for the clinical follow-up of CNV. It offers interesting non-subjective data of retinal sensitivity of patients with macular diseases treated with PDT. In addition we obtained a central retinal sensitivity map where we were able to evaluate the extent and depth of retinal damage
