title: Early multifocal electroretinogram findings during intravitreal ranibizumab treatment for neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate changes in the multifocal electroretinogram (mfERG) in patients with neovascular age-related macular degeneration (nAMD) undergoing ranibizumab treatment.
  
  
  METHODS
  This was an observational, longitudinal, prospective study. Treatment-naive patients with nAMD who met the inclusion and exclusion criteria underwent a course of monthly injections of ranibizumab over 3 months. At baseline and month 3, each subject was evaluated with best corrected visual acuity (BCVA), contrast sensitivity (CS), fluorescein and indocyanine green angiography, optical coherence tomography (OCT), and mfERG. Additional mfERGs were performed at weeks 1 and 4 and BCVA and OCT at weeks 4 and 8.
  
  
  RESULTS
  Eighteen patients were enrolled. Between baseline and week 12, median BCVA improved from 59 to 69 ETDRS letters (P = 0.001), median CS improved from 29 to 30 letters (P = 0.05), mean OCT central foveal subfield thickness (CFT) decreased from 294 to 199 μm (P = 0.005), mean P1 amplitude density of the mfERG central zone increased from 35.85 to 51.55 nV/deg(2) (P = 0.009). The mfERG response correlated positively with BCVA (F = 22; P < 0.0001) and negatively with CFT (F = 12.73; P = 0.00078).
  
  
  CONCLUSIONS
  Intravitreal ranibizumab therapy appears to induce an increase in mfERGs centrally in patients with nAMD at least in the short term. Longer term studies to investigate the prognostic value of mfERG responses to predict changes in visual acuity in nAMD and other diseases are warranted. (ClinicalTrials.gov number, NCT01023971.).
authors.affiliation: Department of Eye and Vision Sciences, University of Liverpool, Liverpool, United Kingdom. claudio.campa@yahoo.com
authors.forename: Claudio
authors.initials: C
authors.lastname: Campa
authors.forename: Richard
authors.initials: R
authors.lastname: Hagan
authors.forename: Jayashree N
authors.initials: JN
authors.lastname: Sahni
authors.forename: Malcolm C
authors.initials: MC
authors.lastname: Brown
authors.forename: Nicholas A V
authors.initials: NA
authors.lastname: Beare
authors.forename: Heinrich
authors.initials: H
authors.lastname: Heimann
authors.forename: Simon P
authors.initials: SP
authors.lastname: Harding
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D015350:Contrast Sensitivity / Q000502:physiology; D004596:Electroretinography / Q000187:drug effects*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab; D012160:Retina / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab