Electroretinogram Changes Following Sequential Panretinal Photocoagulation for Proliferative Diabetic Retinopathy
Received 7 February 2020
Accepted for publication 13 March 2020
Published 30 March 2020 Volume 2020:14 Pages 967—975
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Hassan Khojasteh,1 Rasoul Amini Vishte,2 Ali Mirzajani,2 Elias Khalili Pour,1 Fatemeh Bazvand,1 Hamid Riazi-Esfahani,1 Masoud Mirghorbani,1 Bobeck S Modjtahedi3– 5
1Department of Ophthalmology, Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; 3Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, CA, USA; 4Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA; 5Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park, CA, USA
Correspondence: Hassan Khojasteh Email firstname.lastname@example.org
Purpose: To evaluate changes in electroretinogram (ERG) response over the course of multiple sessions of panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PRP).
Methods: A prospective cohort study of 11 patients with PDR who required PRP was conducted. PRP was completed over three sessions. Each patient had five ERGs done: baseline, 1 week after each PRP session, and 6 weeks after the last session of PRP. Dark-adapted 0.01 ERG, Dark-adapted 3 ERG, Dark-adapted 10 ERG, Light- adapted 3 ERG, and Light-adapted 30 Hz flicker ERG were done. The mean change in a- and b-wave amplitudes as well as implicit times compared to baseline was analyzed.
Results: A significant reduction in peak amplitudes of both a- and b-waves and delay in latencies were observed in all responses (p< 0.05). The absolute amplitude reduction and delay in latency were higher for scotopic b-waves (p< 0.05). The root mean square (RMS) of Dark-adapted 10.0 ERG (p< 0.05) and total mean amplitude changes of a- and b-waves (p< 0.001) were reduced after each laser session; however, the magnitude of change was not different between the first, second, or third sessions of PRP, and each session showed a similar deterioration rate of ERG parameters comparing to each other (p=0.4 for RMS and p=0.2 for total mean amplitude changes). In addition, the results indicated recovery of the amplitude and latency of ERG waves after 6 weeks from the final treatment (p< 0.001) although not to baseline levels.
Conclusion: ERG findings following PRP show reduced retinal function after each session which partially recovers by 6 weeks after the completion of therapy. Clinicians should be mindful of these changes when planning the treatment course for patients with PDR.
Keywords: diabetic retinopathy, electroretinogram, panretinal photocoagulation, laser
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]