Zastosowanie elektroretinogramu typu „pattern” w oszacowaniu skuteczności doszklistkowego leczenia bewacyzumabem (Avastinem) chorych na wysiękową postać zwyrodnienia plamki związanego z wiekiem
Diagnostic Value of Pattern Electroretinogram Test in Estimation of the Effectiveness of Bevacizumab Intravitreal Injections (Avastin) in Patients with Exudative Age-related Macular Degeneration
Krzysztof Szmatłoch, Wojciech Lubiński, Katarzyna Mozolewska-Piotrowska, Jolanta Gronkowska-Serafin, Zbigniew Szych, Danuta Karczewicz
Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. PUM, FEBO
Summary: Purpose: To analyse pattern electroretinogram test results, and its comparison with visual acuity, foveal thickness and retinal circulation before and after intravitreal injections of bevacizumab in eyes with exudative age-related macular degeneration. Material and methods: Thirty one eyes of 30 patients (mean of age 72.5±9.59 years), with exudative age-related macular degeneration were treated with intravitreal injections of bevacizumab (inclusion criteria based on fluorescein angiography). Each patient received three injections with interval period 4–6 weeks. At baseline, 6 and 12 months from baseline the following examinations were performed: logMAR distance best corrected visual acuity test, pattern electroretinogram recording and foveal thickness optical coherence tomography. Additionally fluorescein angiography carried out and analyzed at baseline and 12 months after. Results: Six and 12 months from baseline, the distance best corrected visual acuity and pattern electroretinogram results did not differ significantly. Significant reduced thickness in the foveal region was noticed only after six months (p=0.02). Significant negative correlation between distance best corrected visual acuity and foveal thickness was found in 6 months from baseline (p=0.03). Analysis of the remaining parameters did not reveal significant correlations. One year from baseline reduction of leakage dye in fluorescein angiography was observed although this difference was not significant. At 12 months follow-up the only statistically significant difference was detected in size of active choroidal neovascularization, which was reduced in comparison to baseline value p=0.000005. Conclusions: In 12 months follow-up, in patients with exudative age-related macular degeneration treated with bevacizumab injections stabilisation of macular function was observed and confirmed in pattern electroretinogram test. Pattern electroretinogram test seems to be a good additional tool for monitoring of bevacizumab treatment. Results of our study suggest that this type of treatment slow-down progression of exudative age-related macular degeneration.
Słowa kluczowe: siatkówka, zwyrodnienie plamki związane z wiekiem (AMD), leczenie bewacyzumabem, ostrość wzroku, elektroretinogram typu „pattern” (PERG), grubość dołka, optyczna koherentna tomografia (OCT), funkcja plamki, krążenie siatkówkowe.
Keywords: retina, age-related macular degeneration (AMD), bevacizumab treatment, visual acuity, pattern electroretinogram foveal thickness, optical coherence tomography (OCT), macular function, retinal circulation, pattern electroretinogram test (PERG).