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Macular function following intravitreal ranibizumab for macular edema associated with branch retinal vein occlusion

  • Tomoharu Nishimura
  • Shigeki MachidaEmail author
  • Atsushi Tada
  • Eiki Oshida
  • Tetsuya Muto
Original Research Article
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Abstract

Purpose

To determine the physiology of the macula by the focal macular electroretinograms (fmERGs) in patients with branch retinal vein occlusion with macular edema (BRVOME) treated by intravitreal injections of ranibizumab (IVR).

Methods

We studied 17 eyes of 17 patients with BRVOME. The contralateral unaffected eyes served as controls. All patients were treated with an IVR at monthly intervals for 3 consecutive months. The baseline best-corrected visual acuity (BCVA), optical coherence tomographic (OCT) findings, and fmERGs were compared to the post-treatment values. The fmERGs were elicited by a 15° circular spot or a superior or inferior semicircular spot. The center of the spot was placed on the fovea. The amplitudes of the a- and b-waves, photopic negative response (PhNR), and sum of the oscillatory potentials (ΣOPs: sum of OP1, OP2, and OP3 amplitudes) were measured. In addition, the implicit times of the a- and b-waves were also measured.

Results

The BCVA improved significantly from 0.39 ± 0.28 logMAR units to 0.17 ± 0.18 logMAR units after the resolution of the central macular edema (P < 0.01). All components of the fmERGs elicited by the semicircular stimulus spot placed on the occluded side were smaller than that elicited from the corresponding area of the control eyes. The b-wave amplitudes increased significantly from 0.49 ± 0.25 to 0.75 ± 0.36 µV following the IVR injections, but the amplitudes of the a-wave and PhNR remained reduced (P < 0.05). The amplitudes of the PhNR and ΣOPs elicited by stimulating the non-occluded side were reduced with relative preservation of the a- and b-waves (P < 0.05). They recovered after the treatment from 0.27 ± 0.15 to 0.50 ± 0.30 and 0.33 ± 0.15 to 0.53 ± 0.19 µV, respectively.

Conclusions

IVRs improved the macular function not only on the occluded side but also on the non-occluded side. On the occluded side, the BRVOME affects the function of all retinal layers of the macula. Even after the IVR, the function of the photoreceptors and retinal ganglion cells remained abnormal. On the non-occluded side, the inner retinal function improved after the IVR.

Keywords

Macular function Macular edema BRVO Focal macular ERG Ranibizumab 

Notes

Acknowledgements

Funding/Support: This study was supported by JSPS KAKENHI Grant No. 18K09420 (SM). We thank Dr. Duco Hamasaki for editing the manuscript.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Statement of human rights

This research was conducted in accordance with the Institutional Guidelines of Dokkyo Medical University, and the procedures conformed to the tenets of the Declaration of Helsinki.

Informed consent

An informed consent was obtained from all subjects after a full explanation of the nature of the experiments.

Statement on the welfare of animals

No animals were used in this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Tomoharu Nishimura
    • 1
  • Shigeki Machida
    • 1
    Email author
  • Atsushi Tada
    • 1
  • Eiki Oshida
    • 1
  • Tetsuya Muto
    • 1
  1. 1.Department of OphthalmologyDokkyo Medical University Saitama Medical CenterKoshigayaJapan

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