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Lee, Chang, and Ahn: Correlation Between Multifocal Electroretinography and Visual Acuity After Resolution of Diabetic Macular Edema
Original Article

J Korean Ophthalmol Soc 2010;51(1):29-34.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.1.29

Correlation Between Multifocal Electroretinography and Visual Acuity After Resolution of Diabetic Macular Edema

Kwan Hoon Lee, MD, Moo Hwan Chang, MD, Jung Hyun Ahn, MD

Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea

Address reprint requests to Moo Hwan Chang, MD Department of Ophthalmology, Dankook University College of Medicine #San 16-5 Anseo-dong, Cheonan 330-715, Korea Tel: 82-41-550-6377, Fax: 82-41-561-0137, E-mail: changmh@dankook.ac.kr

Received 6 March 2009       Accepted 22 September 2009

Copyright © 2010 Korean Ophthalmological Society

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 prognostic value of multifocal electroretinography (mfERG) after a decrease of retinal thickness in eyes with diabetic macular edema (DME).

Methods

Sixty patients (60 eyes) underwent intravitreal injection of triamcinolone acetonide or bevacizumab for diabetic macular edema. Eyes were divided into three groups, according to foveal thickness: Group A (<500 μ m, n=20 eyes), Group B (500 μ m≦ <800 μ m, n=20 eyes), and Group C (≧800 μ m, n=20 eyes). Best-corrected visual acuity (BCVA) and mfERG responses from the most central seven hexagons were analyzed both before and after treatment.

Results

The preinjection P1 amplitudes of mfERG correlated significantly with end-point BCVA in Groups A and B (p<0.05), but did not correlate with end-point BCVA (p>0.05) in Group C.

Conclusions

The level of P1 amplitudes of mfERG may be a useful tool to predict visual outcomes after a decrease of retinal thickness in patients with diabetic macular edema.

Keywords: Diabetic macular edema, Multifocal electroretinography, Visual acuity

References

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Figure 1.
Stimulus array of 61 hexagonal elements; ring 1 (red) and ring 2 (blue) correspond to the fovea and parafovea, respectively.
jkos-51-29f1.tif
Figure 2.
The typical waveform of the primary multifocal ERG response is a biphasic wave with initial negative deflection followed by a positive peak. There may be a second negative deflection after the peak. The preferred designation is to label these three peaks respectively N1, P1, and N2.
jkos-51-29f2.tif
Figure 3.
Scattergram demonstrating the relation between preinjection P1 amplitudes and end point BCVA in three groups. Group A (r=-0.772, p<0.001) and B (r=-0.651, p=0.001) show that preinjection P1 amplitude significantly related to the end point BCVA, but in group C, no significant relation between preinjection P1 amplitude and end point BCVA.
jkos-51-29f3.tif
Figure 4.
Comparison of P1 amplitudes of Group A, B and C between preinjection and end point state. The box- and -whiskers plots include the 25 th, 50 th, and 75 th percentiles. The whiskers define the minimum and maximum values.
jkos-51-29f4.tif
Table 1.
Comparison of clinical data of three groups
Group A Group B Group C p-value
Number of eyes 20 20 20
Age (years) 58.4±8.2 60.5±11.1 59.9±10.8 0.916∏
Sex (male/female) 12/8 10/10 13/7 0.619＃
Injection drug (TA*/B†) 18/2 17/3 19/1 0.574＃
Duration of ME (months) 5.1±3.2 6.3±4.9 8.3±4.7 0.102∏
Duration of F/U (weeks) 9.1±3.0 10.9±2.7 11.8±3.2 0.038∏
BCVA (logMAR)‡
   Preinjection 0.77±0.31 0.84±0.38 0.96±0.47 0.322∏
   End-point 0.39±0.28 0.57±0.35 0.79±0.43 0.002∏
Mean foveal thickness (μm)
   Preinjection 431.35±64.41 664.55±84.30 964.80±156.65 <0.001∏
   End-point 208.70±17.73 227.25±25.98 235.55±14.28 <0.001∏
P1 amplitude (nV/deg2)§
   Preinjection 54.96±23.04 40.08±19.89 28.52±14.93 0.001∏
   End-point 72.95±25.68 56.17±22.29 34.21±15.86 <0.001∏

ME=Macular edema; F/U = follow–up

* TA=triamcinolone acetate

† B=bevacizumab

‡ log MAR=log minimal angle of resolution

§ nanovolt/square degrees

∏ Kruskall-Wallis test

＃ chi-square test.

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