Title

ASSOCIATIONS BETWEEN MULTIFOCAL ELECTRORETINOGRAM (MFERG), STANDARD AUTOMATED PERIMETRY (SAP) AND OPTICAL COHERENCE TOMOGRAPHY (OCT) IN NON-ACUTE VOGT-KOYANAGI-HARADA DISEASE (VKHD)

Introduction

The purpose was to evaluate associations between functional (SAP and mfERG) and structural (OCT) measurements in patients with non-acute VKHD

Methods

Cross-sectional study (Jul/Dec 17) with 18 patients with VKHD followed for minimum 12mo from disease onset with systematic evaluation and treatment protocols. SAP: central 24-2 Swedish Interactive Threshold Algorithm standard on Humphrey Visual Field Analyzer II®; mean sensitivity (MS): 52 test points excluding points immediately above and below blind spot; central sensitivity (CS): average value at 4 central points; values in decibel and linear 1/L units. OCT: Spectralis® linear 30 degrees horizontal and vertical scanning of fundus area centered on macular umbo. mfERG (61 hexagons): RETiscan System® following the International Society for Clinical Electrophysiology of Vision guidelines; P1 and N1 amplitudes and peak times calculated after excluding ring 5 values. Age and gender matched controls were included for SAP and mfERG. Generalized estimated equations were used for analyzing binary ocular data, Pearson correlation for correlations. This study was approved by Institutional Ethics Committee and followed Helsinki declaration

Results

SAP and mfERG parameters were significantly worse in VKHD patients than in normal controls. There were significant correlations between P1 and N1 amplitudes and MS (r=0.342 and r=0.381, p=0.041 and p=0.022, respectively); P1 and N1 peak times and MS (r=-0.364 and r=-0.345, p=0.029 and p=0.039, respectively); foveal thickness and N1 amplitude and P1 peak time (r=-0.354 and r=0.509, p=0.034 and p=0.002, respectively). Disrupted photoreceptors integrity on OCT was associated with decreased P1 and N1 amplitudes (p= 0.050 and p= 0.002, respectively) and reduced CS, fovea, PSD and MD values on SAP (p=0.007; p=0.045; p= 0.014 and p=0.011, respectively)

Discussion

Measurements of SAP, mfERG and OCT correlated significantly with each other in patients with non-acute VKHD and were significantly worse than in controls.

Keywords

Uveitis; uveomeningoencephalitic syndrome; inflammation; electrophysiology; visual fields

Area

CLINICAL CASE

Authors

Fernanda Maria Silveira Souto, Ruy Felippe Brito Gonçalves Missaka, Marcelo Mendes Lavezzo, Viviane Mayumi Sakata, Maria Kiyoko Oyamada, Carlos Eduardo Hirata, Joyce Hisae Yamamoto