Electroretinographic evaluations of retinal function before, just after, and after intravitreal injections.

Kazuma Yagura,Makoto Kawashima,Emiko Watanabe,Atsushi Mizota,Yozo Miyake,Kei Shinoda,Soiti Matsumoto,Harue Matsumoto,Takeshi Iwata,Gaku Terauchi

doi:10.1038/srep31104

Kazuma Yagura, Makoto Kawashima + Show 8 more

Open Access

https://doi.org/10.1038/srep31104

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Abstract

Intravitreal injections (IVI) have become a part of daily practice for a growing number of procedures. We evaluated the retinal function by recording intraoperative photopic electroretinograms (ERGs) before an injection (T1), just after the injection (T2), and after the aspiration of the anterior chamber fluid (T3) of 19 eyes of 19 patients (mean age 70.6 years; men = 11) who received an IVI of an anti-vascular endothelial growth factor. The mean amplitudes of the b-wave, photopic negative responses (PhNR), and oscillatory potentials (OPs) 1 and 2 at T2 were significantly smaller than that at T1, but no significant difference was observed between T3 and T1. The mean implicit times of the a-wave and OP1, 2, and 3 at T2 and the a-wave and the OP2 at T3 were significantly longer than that at T1. The mean intraocular pressure (IOP) at T2 (49.32 mm Hg) was significantly higher and the IOP at T3 (8.74 mm Hg) was significantly lower than that at T1 (21.05 mm Hg). The retinal function was reduced and the IOP elevated just after the IVI. The response of each ERG component was different suggesting a different sensitivity of each type of retinal neuron to IVI.

Highlights

Intravitreal injections (IVI) have become a part of daily practice for a growing number of procedures
An intravitreal injection of anti-vascular endothelial growth factor agents has become a common procedure for several types of retinal diseases, e.g., exudative age-related macular degeneration (AMD), macular edema associated with retinal vein occlusion (RVO), diabetic retinopathy, and other retinal diseases associated with vascular abnormalities[1,2,3,4,5,6,7,8]
Electrophysiological evaluations of retinal function during eye surgery was first reported by Miyake et al.[19,20,21]

Summary

Introduction

Intravitreal injections (IVI) have become a part of daily practice for a growing number of procedures. We evaluated the retinal function by recording intraoperative photopic electroretinograms (ERGs) before an injection (T1), just after the injection (T2), and after the aspiration of the anterior chamber fluid (T3) of 19 eyes of 19 patients (mean age 70.6 years; men = 11) who received an IVI of an antivascular endothelial growth factor. Miyake and colleagues[19,20,21] recorded intraoperative electroretinograms (ERGs) during vitreous surgery and reported a reduction in the amplitude and prolongation of the implicit time of the 30 Hz flicker ERGs. an accurate evaluation of each type of retinal cells was not performed, and measurements of the IOP were not made. We recorded photopic ERGs and measured the IOPs before and just after the intravitreal injection. The photopic ERGs allowed us to do detailed analyses of the function of the cone pathway, and we were able to evaluate the changes in the cone-driven retinal function before, during, and after the IVI

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