Electrophysiological and Morphological Changes After Intravitreal Bevacizumab Injection with Macular Edema or Choroidal Neovascularization

Hyun Joon Lee; Joo Youn Park; Young-Hoon Ohn

doi:10.3341/jkos.2009.50.12.1824

Journal List > J Korean Ophthalmol Soc > v.50(12) > 1008446

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Lee, Park, and Ohn: Electrophysiological and Morphological Changes After Intravitreal Bevacizumab Injection with Macular Edema or Choroidal Neovascularization

Original Article

J Korean Ophthalmol Soc 2009;50(12):1824-1830.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.12.1824

Electrophysiological and Morphological Changes After Intravitreal Bevacizumab Injection with Macular Edema or Choroidal Neovascularization

Hyun Joon Lee, MD¹, Joo Youn Park, MD², Young-Hoon Ohn, MD, PhD²

¹Department of Ophthalmology, Soonchunhyang University College of Medicine, Cheonan, Korea

²Department of Ophthalmology, Soonchunhyang University College of Medicine, Bacheon, Korea

Address reprint requests to Young-Hoon Ohn, MD, Department of Ophthalmology, Soonchunhyang University College of Medicine #1174 Jung-dong, Wonmi-gu, Bucheon 420-767, Korea Tel: 82-32-621-5053, Fax: 82-32-621-5435, E-mail: yhohn@schbc.ac.kr

Received 29 May 2009 Accepted 13 October 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the functional and anatomical statuses of macula with multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) for the treatment of patients with macular edema after intravitreal bevacizumab injection.

Methods

Patients were injected with intravitreal bevacizumab (1.875 mg/0.075 ml) for macular edema with choroidal neovascularization (CNV), diabetic retinopathy and retinal vein occlusion.

The mfERG and OCT were performed. The results of mfERG were divided into fovea (Ring 1) and parafovea (Ring 2), and amplitude and implicit time were compared. The central macular thickness of OCT and visual acuity were compared with parameters of mfERG.

Results

A total of 120 eyes (96 patients) were diagnosed with diabetic retinopathy, CNV with age-related macular degeneration and retinal vein occlusion. Visual acuity improved from logMAR 0.85±0.39 to 0.54±0.38 after intravitreal bevacizumab injection. The implicit time of P1 and N2 in mfERG decreased, and the amplitude of P1 showed a statistically significant increase. Central macular thickness decreased from 374.4±135.2 μ m to 249.0±72.0 μ m.

Conclusions

After intravitreal bevacizumab injection, functional and anatomical statuses of mfERG and OCT improved. This study demonstrates a method for utilizing mfERG to assess the effectiveness of treatments such as bevacizumab.

Keywords: Choroidal neovascularization, Intravitreal Bevacizumab injection, Macular edema, Multifocal electroretinogram

References

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Figure 1.

Changes in plot of mfERG after intravitreal bevacizumab injection; implicit time was shortened and retinal response densities were increased on ring 1 and 2 areas of mfERG after IVB injection. Peak of retinal response densities of macular area were recovered on 3-D plot after IVB injection.^* IVB=intravitreal bevacizumab injection.

Figure 2.

Changes in visual acuity (logMAR) after intravitreal bevacizumab injection (IVB) among diseases. ^* DME=diabetic macular edema; ^† CNV=choroidal neovascularization; ^‡ RVO=retinal vein occlusion; ^§ P=paired t –test.

Figure 3.

Changes in parameters of multifocal electroretinogram before and after intravitreal injection. ^* r=pearson's correalation.

Figure 4.

Changes in central macular thickness after intravitreal bevacizumab injection among diseases.^* DME=diabetic macular edema; ^† CNV=choroidal neovascularization; ^‡ RVO=retinal vein occlusion; ^§ p=paired t-test.

Table 1.

Distribution of eyes undergoing intravitreal bevacizumab injection

N	120
M/F	67/53
Mean age (years)	59.9±18.7
Mean f/u^*	7.5±4.3
Mean number of injection (range)	1.93±1.18 (1∼7)
DM^† retinopathy	48
CNV^‡ with ARMD^§	57
RVO^П	15

^* f/u=follow up (months)

^† DM=diabetes mellitus

^‡ CNV=choroidal neovascularization; ARMD=age related macular degeneration

^П RVO=retinal vein occlusion.

Table 2.

Correlation parameters with visual acuity and central macular thickness

	Ring 1 Implicit time				Ring 2 Implicit time
	P1		N2		P1		N2
	r^*	p	r^*	p	r^*	p	r^*	p
VA^†	−0.039	0.676	0.064	0.488	−0.002	0.986	−0.096	0.299
CMT^‡	−0.046	0.616	−0.053	0.564	0.078	0.396	0.027	0.769

^* Pearson's correlation

^† VA=visual acuity (logMar)

^‡ CMT=central macular thickness.

Table 3.

Correlation parameters of multifocal electroretinogram with visual acuity and central macular thickness

	DM	CNV with ARMD	RVO
VA^*	No significance	No significance	Ring 1 P1 implicit time (r=-0.527 p=0.044^‡)
CMT^†	Ring 2 P1 implicit time (r=0.303, p=0.036^‡)	No significance	Ring 1 P1 implicit time (r=-0.579 p=0.024^‡)

^* VA=visual acuity

^† CMT=central macular thickness

^‡ Statistically significant with Pearson's correlation coefficient (p<0.05).

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