Evaluation of treatment efficacy of intravitreal ranibizumab injections in patients with wet type of AMD.

PURPOSE: To evaluate foveal function, retinal circulation and foveal thickness before and after intravitreal ranibizumab injections in eyes with wet type of age-related macular degeneration (AMD). MATERIAL AND METHODS: The study group consisted of 21 eyes (20 patients) with choroidal neovascularisation (CNV) due to AMD. Inclusion criteria were based on fluorescein angiography (FA) and distance best corrected visual acuity (DBCVA)--log MAR scale. In each eye, 3 consecutive injections of ranibizumab every 4 weeks were administered and then individual course for re-injections according to DBCVA and optical coherence tomography (OCT) up to 12 months was applied. At baseline, 3, 6 and 12 months follow-up, the following tests were performed: DBCVA, multifocal electroretinogram (mfERG) and OCT. Additionally, FA was carried out before the treatment, 3 and 12 months from the baseline. RESULTS: At baseline, FA revealed mainly minimally occult choroidal neovascularisation--57% (12/21) of eyes. At 3 months choroidal neovascularisation diameter was stable; no leakage from active choroidal neovascularisation was seen in 76% (16/21) of eyes. After 12 months follow-up, increase in choroidal neovascularisation diameter was seen in 43% (9/21) of eyes and no leakage in 57% (12/21) of cases. The mean DBCVA significantly improved only after 3 months (p < 0.02). Significant decrease of mean foveal thickness was observed in each follow-ups (p < 0.01). The mfERG data from the macular region remained stable or improved slightly in some cases. CONCLUSIONS: In our series of patients with the wet type of AMD after intravitreal injections of ranibizumab in 12 months follow-up, the reduction of foveal thickness was noted while DBCVA and the bioelectrical function from the macular region measured by the mfERG remained stable.

Pattern electroretinogram (PERG) and pattern visual evoked potential (PVEP) in the early stages of Alzheimer's disease.

Alzheimer's disease (AD) is one of the most common causes of dementia in the world. Patients with AD frequently complain of vision disturbances that do not manifest as changes in routine ophthalmological examination findings. The main causes of these disturbances are neuropathological changes in the visual cortex, although abnormalities in the retina and optic nerve cannot be excluded. Pattern electroretinogram (PERG) and pattern visual evoked potential (PVEP) tests are commonly used in ophthalmology to estimate bioelectrical function of the retina and optic nerve. The aim of this study was to determine whether retinal and optic nerve function, measured by PERG and PVEP tests, is changed in individuals in the early stages of AD with normal routine ophthalmological examination results. Standard PERG and PVEP tests were performed in 30 eyes of 30 patients with the early stages of AD. The results were compared to 30 eyes of 30 normal healthy controls. PERG and PVEP tests were recorded in accordance with the International Society for Clinical Electrophysiology of Vision (ISCEV) standards. Additionally, neural conduction was measured using retinocortical time (RCT)--the difference between P100-wave latency in PVEP and P50-wave implicit time in PERG. In PERG test, PVEP test, and RCT, statistically significant changes were detected. In PERG examination, increased implicit time of P50-wave (P < 0.03) and amplitudes reductions in P50- and N95-waves (P < 0.0001) were observed. In PVEP examination, increased latency of P100-wave (P < 0.0001) was found. A significant increase in RCT (P < 0.0001) was observed. The most prevalent features were amplitude reduction in N95-wave and increased latency of P100-wave which were seen in 56.7% (17/30) of the AD eyes. In patients with the early stages of AD and normal routine ophthalmological examination results, dysfunction of the retinal ganglion cells as well as of the optic nerve is present, as detected by PERG and PVEP tests. These dysfunctions, at least partially, explain the cause of visual disturbances observed in patients with the early stages of AD.

[Electrophysiological changes in patients with early stages of Alzheimer's disease]. / Zmiany elektrofizjologiczne u pacjentów we wczesnym stadium choroby Alzheimera.

PURPOSE: An evaluation of retinal and optic nerve bioelectrical function in patients with early stages of Alzheimer's disease. MATERIALS AND METHODS: 30 eyes of 15 patients in the early stage of Alzheimer's disease with normal eye fundus appearance were analysed. Electrophysiological tests of the retina and optic nerve (FVEP, PVEP, PERG, ERG) were performed according to ISCEV standards. RESULTS: The dysfunction of the retina and optic nerve was observed. The most common abnormalities were noted in PVEP test (latency increase of P100-wave--36.7% eyes) and in PERG test (latency increase of P50-wave--33.3% eyes). CONCLUSION: In patients with early stage of Alzheimer's disease there is a dysfunction of the retina and optic nerve, which can be detected by electrophysiological tests, even in patients with normal eye fundus.