Focal macular electroretinograms after photodynamic therapy combined with posterior juxtascleral triamcinolone acetonide.
OBJECTIVE
Retinal function is commonly depressed transiently after photodynamic therapy (PDT). Additional treatment may prevent this impaired retinal function. The purpose of this study was to determine the changes in the focal macular electroretinograms (FMERGs) after PDT combined with TA for age-related macular degeneration.


METHODS
Thirty-four eyes that were successfully treated by PDT with a posterior juxtascleral injection of TA were studied. FMERGs, optical coherence tomography, and indocyanine green angiography were performed before and after the PDT.


RESULTS
The mean amplitudes of the FMERGs were not significantly decreased 1 week after PDT with TA (P > 0.05). The mean ratio of the FMERG b-wave 1 week after PDT to that before PDT was 1.09, with an indistinct hypofluorescence at the site of the PDT (18 eyes), and the ratio was 0.91 in the eyes with a distinct hypofluorescence border (16 eyes; P < 0.05).


CONCLUSIONS
The combined use of TA with PDT mitigated the depression of retinal function soon after PDT. However, there were cases of severe choroidal hypoperfusion corresponding to the site of the laser spot that impaired retinal function in comparison to cases with mild hypoperfusion. Even with severe choroidal hypoperfusion, the deterioration in retinal function was relatively mild, with the b-wave FMERG reduced by only 10%.
Ishikawa
Kohei
K
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Japan. kohei@med.nagoya-u.ac.jp
Nishihara
Hiroaki
H
Ozawa
Shinsuke
S
Piao
Chang-Hua
CH
Ito
Yasuki
Y
Kondo
Mineo
M
Terasaki
Hiroko
H
D000368:Aged; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000503:physiopathology; D004396:Coloring Agents; D003131:Combined Modality Therapy; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D008266:Macula Lutea / Q000503:physiopathology*; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D012590:Sclera; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D000077362:Verteporfin
D004396:Coloring Agents; D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green