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Structures affecting recovery of macular function in patients with age-related macular degeneration after intravitreal ranibizumab

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine the retinal structures affecting the recovery of macular function in patients with exudative age-related macular degeneration (AMD) treated with intravitreal ranibizumab (IVR).

Method

Thirty eyes of 30 patients with exudative AMD who were treated with IVR at monthly intervals for 3 months were studied. Focal macular electroretinograms (fmERGs) and spectral-domain optical coherence tomography (SD-OCT) were performed before and 3 months after beginning the IVR injections. The fmERGs were elicited by a 15° white stimulus spot centered on the fovea. The thickness of different retinal layers, presence of a serous retinal detachment (SRD), and presence of a pigment epithelial detachment (PED) at the fovea was determined in the SD-OCT images. Measurements were made of the inner, middle, and outer layers of the retina and also of the SRD and PED in the horizontal and vertical meridians at 1.2 mm from the fovea (parafoveal regions). The significance of the correlations between these structural parameters and the a-wave amplitude of the fmERG was determined.

Results

There was no significant correlation between the structural parameters of the fovea and the a-wave amplitude. In the parafoveal regions, the thickness of the outer retinal layer was significantly correlated with an increase of the a-wave amplitude (R = 0.56, P = 0.001). In addition, the SRD thickness was negatively and significantly correlated with the a-wave amplitude (R = −0.54, P = 0.002). The change in the parafoveal SRD thickness after IVRs was the only independent determinant of recovery of the a-wave amplitude after the treatments (P < 0.05).

Conclusions

The macular function measured by the fmERGs was determined by the parafoveal outer layer and SRD thickness in patients with exudative AMD. Of these, changes in the SRD thickness by IVRs most strongly affected the recovery of macular function.

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Acknowledgments

Funding/Support

This study was supported by JSPS KAKENHI Grant No. 24592677 (SM). We thank Professor Duco Hamasaki for discussions and editing the manuscript.

Contributions of Authors

Design of the study (TN, SM, DK), conduct of the study (TN, SM), data analysis: (TN, KH, SM).

Statement about Conformity with Author Information

Institutional Review Board of Iwate Medical University approved this research.

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Authors and Affiliations

  1. Department of Ophthalmology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan

    Tomoharu Nishimura, Shigeki Machida, Kouhei Hashizume & Daijiro Kurosaka

  2. Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan

    Shigeki Machida

Authors
  1. Tomoharu Nishimura
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  2. Shigeki Machida
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  3. Kouhei Hashizume
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  4. Daijiro Kurosaka
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Correspondence to Shigeki Machida.

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Nishimura, T., Machida, S., Hashizume, K. et al. Structures affecting recovery of macular function in patients with age-related macular degeneration after intravitreal ranibizumab. Graefes Arch Clin Exp Ophthalmol 253, 1201–1209 (2015). https://doi.org/10.1007/s00417-014-2779-z

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  • DOI: https://doi.org/10.1007/s00417-014-2779-z

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