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  Vol. 123 No. 8, August 2005 TABLE OF CONTENTS
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Changes in Multifocal Electroretinograms Induced by Transpupillary Thermotherapy

Yoshiaki Shimada, MD; Masayuki Horiguchi, MD

Arch Ophthalmol. 2005;123:1066-1072.

Objective  To determine retinal function after transpupillary thermotherapy (TTT) for subfoveal choroidal neovascularization using multifocal electroretinograms (mfERGs).

Methods  Multifocal electroretinograms were recorded before and after TTT (wavelength, 810 nm; diameter, 3 mm; duration, 60 seconds; power, 350 mW) in 9 eyes in 9 patients with subfoveal choroidal neovascularizations. The stimulus consisted of 7 hexagons; the central hexagon covered the laser-irradiated area and the surrounding 6 hexagons covered the nonirradiated area. Each recording was completed within 1 minute, and mfERGs were recorded periodically during the first 60 minutes after TTT and also at 24 hours and 1 week after TTT.

Results  The amplitude of mfERGs from irradiated areas was significantly reduced at 1 minute after TTT (P<.01) and then recovered soon. The peak time was prolonged at 15 minutes after TTT (P<.01), recovered to pre-TTT levels at 60 minutes, and then was prolonged again at 24 hours (P<.05) and 1 week (P<.05) after TTT. The mfERGs in nonirradiated areas were unchanged during the observational period.

Conclusions  We found amplitude reduction in central focal ERGs at 1 minute after TTT, transient peak-time delay at 15 minutes, and a delay at 24 hours. Early reduction is probably directly caused by an increase in temperature during TTT as previously reported in focal flicker ERGs. Peak-time delays at 15 minutes and 24 hours may be caused by other factors, such as increased intracellular calcium (Ca2+), the release of nitric oxide or heat shock proteins, vasodilation, or change in choroidal neovascularization. Our findings indicate that recording mfERGs may be a useful tool for evaluating TTT procedures.


Author Affiliations: Department of Ophthalmology, School of Medicine, Fujita Health University, Aichi, Japan.



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