title: Best-corrected visual acuity and retinal thickness are associated with improved cortical visual processing in treated wet AMD patients.
abstract: OBJECTIVE
  In response to anti-VEGF treatment for wet AMD retinal anatomy and visual acuity is often remedied. In our previous study, we showed that visual evoked potentials (VEP) improve following successful anti-VEGF treatment. The aim of this study was to investigate, how visual acuity and retinal thickness changes are reflected in VEP parameters. Moreover, we wanted to assess the feasibility of VEP as a novel monitoring tool for wet AMD patients.
  
  
  METHODS
  A total of 16 patients and six control subjects were enrolled in this study. Patients received three bevacizumab intravitreal injections. At the beginning of the study and four to 6 weeks after the last injection, the best-corrected visual acuity (BCVA) test, full biomicroscope examination, OCT analysis and VEP were performed.
  
  
  RESULTS
  In treated eyes, logMAR visual acuity improved on average 0.18 ± 0.32 units, OCT retinal thickness decreased 170 ± 200 micrometres and VEP amplitude increased 1.0 ± 1.4 microvolts. All changes were significant at p < 0.05. There was a significant correlation between the relative changes of VEP amplitude and retinal thickness r = -0.630 (p < 0.05), and between visual acuity (logMAR) and retinal thickness r = 0.576 (p < 0.05).
  
  
  CONCLUSIONS
  We showed that both the increase in VEP amplitude and the improvement in visual acuity are associated with the decrease in retinal thickness in treated wet AMD patients. The results do not indicate additional usefulness of VEP in the diagnosis or monitoring of wet AMD.
authors.affiliation: Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Vottonen
authors.affiliation: Department of Clinical Neurophysiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Pääkkönen
authors.affiliation: Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Ina M
authors.initials: IM
authors.lastname: Tarkka
authors.affiliation: Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.|Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Kai
authors.initials: K
authors.lastname: Kaarniranta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D014793:Visual Cortex / Q000503:physiopathology*; D014795:Visual Pathways / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: age-related eye diseases; exudative age-related macular degeneration; optical coherence tomography; visual acuity; visual evoked potential