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Article Type

Article

Subject Area

Ophthalmology

Abstract

Background Diabetic retinopathy and clinically significant macular edema are largely responsible for the irreversible, debilitating visual impairment. There is evidence suggesting that some of the diabetes-related visual abnormalities are due to neurodegeneration. Use of objective tests for early detection of retinal dysfunction of sight-threatening diabetic retinopathy would be of great value. Aim The aim was to study the functional improvements of macular functions after treatments with intravitreal injection of ranibizumab as detected with central visual field and multifocal electroretinogram (mfERG). Settings and design A prospective cohort interventional study that included 30 eyes of 30 patients. Materials and methods Prospective cohort interventional study including 30 eyes of 30 patients with nonproliferative diabetic retinopathy with diabetic macular edema who were treated with three doses of intravitreal injection of ranibizumab and then performed optical coherence tomography, Central visual field, and mfERG, to assess macular function as detected with visual acuity measuring by LogMAR acuity testing, central visual field and mfERG. Statistical analysis Parametric data were analyzed with analysis of variance and whenever appropriate with Student's t-test. Nonparametric data were analyzed with χ2 and/or Mann–Whitney tests. Statistical significance was considered at 95% confidence interval. All P values less than 0.05 was considered statistically significant. Results After treatment, visual acuity (VA) of 25 eyes improved, whereas five eyes showed stabilization of VA with the same central foveal thickness (CFT). All measurements of the CFT were decreased. The authors could find significant decreases in the average CFT from baseline (376.16 ± 66.23 months) to 261.58 ± 37.55 months at 3 months. Conclusion VA correlates closely with CFT and P1 amplitude in the central ring of the mf-ERG, where P1 amplitude shows higher sensitivity than with CFT based on optical coherence tomography.

Keywords

diabetic macular edema, diabetic retinopathy, functional improvements of macular functions, intravitreal injection of ranibizumab, multifocal electroretinogram

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