Skip to main content
Top
Published in: Documenta Ophthalmologica 1/2009

01-02-2009

The role of the ERG in the diagnosis and treatment of Age-Related Macular Degeneration

Author: Christina Gerth

Published in: Documenta Ophthalmologica | Issue 1/2009

Login to get access

Abstract

Age-related macular degeneration (AMD) is affecting an increasing number of people, with 2.95 million people estimated to be affected in the USA by 2020. Possible preventive agents, such as vitamins and supplements have been studied and new treatment options for AMD have been developed in recent years. What role does electrophysiology play as a sensitive outcome measure? The most commonly used tests are the full-field electroretinogram (ffERG) and the multifocal ERG (mfERG). Test results from patients with AMD and reduced central vision need special attention in respect to fixation pattern, age-matched control data, and retinal luminance. Advantages, disadvantages and limitations of techniques will be considered, together with a review of published studies.
Literature
1.
go back to reference Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology 99:933–943PubMed Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology 99:933–943PubMed
2.
go back to reference Brown GC, Brown MM, Campanella J, Beauchamp GR (2005) The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration – a value-based reappraisal with 5-year data. Am J Ophthalmol 140:679–687PubMed Brown GC, Brown MM, Campanella J, Beauchamp GR (2005) The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration – a value-based reappraisal with 5-year data. Am J Ophthalmol 140:679–687PubMed
3.
go back to reference Coleman AL, Yu F (2008) Eye-related medicare costs for patients with age-related macular degeneration from 1995 to 1999. Ophthalmology 115:18–25CrossRefPubMed Coleman AL, Yu F (2008) Eye-related medicare costs for patients with age-related macular degeneration from 1995 to 1999. Ophthalmology 115:18–25CrossRefPubMed
4.
go back to reference Klein R, Klein BE, Jensen SC, Meuer SM (1997) The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104:7–21PubMed Klein R, Klein BE, Jensen SC, Meuer SM (1997) The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104:7–21PubMed
5.
go back to reference Bressler NM, Munoz B, Maguire MG et al (1995) Five-year incidence and disappearance of drusen and retinal pigment epithelial abnormalities. Waterman study. Arch Ophthalmol 113:301–308PubMed Bressler NM, Munoz B, Maguire MG et al (1995) Five-year incidence and disappearance of drusen and retinal pigment epithelial abnormalities. Waterman study. Arch Ophthalmol 113:301–308PubMed
6.
go back to reference Bressler NM, Bressler SB, Fine SL (1988) Age-related macular degeneration. Surv Ophthalmol 32:375–413CrossRefPubMed Bressler NM, Bressler SB, Fine SL (1988) Age-related macular degeneration. Surv Ophthalmol 32:375–413CrossRefPubMed
7.
go back to reference Wong T, Chakravarthy U, Klein R et al (2008) The natural history and prognosis of neovascular age-related macular degeneration: a systematic review of the literature and meta-analysis. Ophthalmology 115:116–126CrossRefPubMed Wong T, Chakravarthy U, Klein R et al (2008) The natural history and prognosis of neovascular age-related macular degeneration: a systematic review of the literature and meta-analysis. Ophthalmology 115:116–126CrossRefPubMed
8.
go back to reference Schmidt-Erfurth UM, Pruente C (2007) Management of neovascular age-related macular degeneration. Prog Retin Eye Res 26:437–451CrossRefPubMed Schmidt-Erfurth UM, Pruente C (2007) Management of neovascular age-related macular degeneration. Prog Retin Eye Res 26:437–451CrossRefPubMed
9.
go back to reference Andreoli CM, Miller JW (2007) Anti-vascular endothelial growth factor therapy for ocular neovascular disease. Curr Opin Ophthalmol 18:502–508CrossRefPubMed Andreoli CM, Miller JW (2007) Anti-vascular endothelial growth factor therapy for ocular neovascular disease. Curr Opin Ophthalmol 18:502–508CrossRefPubMed
10.
go back to reference Ferris FL 3rd, Kassoff A, Bresnick GH, Bailey I (1982) New visual acuity charts for clinical research. Am J Ophthalmol 94:91–96PubMed Ferris FL 3rd, Kassoff A, Bresnick GH, Bailey I (1982) New visual acuity charts for clinical research. Am J Ophthalmol 94:91–96PubMed
11.
go back to reference Birch DG, Anderson JL (1992) Standardized full-field electroretinography. Normal values and their variation with age. Arch Ophthalmol 110:1571–1576PubMed Birch DG, Anderson JL (1992) Standardized full-field electroretinography. Normal values and their variation with age. Arch Ophthalmol 110:1571–1576PubMed
12.
go back to reference Weleber RG (1981) The effect of age on human cone and rod Ganzfeld electroretinograms. Invest Ophthalmol Vis Sci 20:392–399PubMed Weleber RG (1981) The effect of age on human cone and rod Ganzfeld electroretinograms. Invest Ophthalmol Vis Sci 20:392–399PubMed
13.
go back to reference Wright CE, Williams DE, Drasdo N, Harding GFA (1985) The influence of age on the electroretinogram and visual evoked potential. Doc Ophthalmol 59:365–384CrossRefPubMed Wright CE, Williams DE, Drasdo N, Harding GFA (1985) The influence of age on the electroretinogram and visual evoked potential. Doc Ophthalmol 59:365–384CrossRefPubMed
14.
go back to reference Seeliger MW, Kretschmann UH, Apfelstaedt-Sylla E, Zrenner E (1998) Implicit time topography of multifocal electroretinograms. Invest Ophthalmol Vis Sci 39:718–723PubMed Seeliger MW, Kretschmann UH, Apfelstaedt-Sylla E, Zrenner E (1998) Implicit time topography of multifocal electroretinograms. Invest Ophthalmol Vis Sci 39:718–723PubMed
15.
go back to reference Fortune B, Johnson CA (2002) The decline of photopic multifocal electroretinogram responses with age is primarily due to pre-retinal optical factors. J Opt Soc Am A 19:173–184CrossRef Fortune B, Johnson CA (2002) The decline of photopic multifocal electroretinogram responses with age is primarily due to pre-retinal optical factors. J Opt Soc Am A 19:173–184CrossRef
16.
go back to reference Gerth C, Garcia SM, Ma L et al (2002) Multifocal electroretinogram: age-related changes for different luminance levels. Graefes Arch Clin Exp Ophthalmol 240:202–208CrossRefPubMed Gerth C, Garcia SM, Ma L et al (2002) Multifocal electroretinogram: age-related changes for different luminance levels. Graefes Arch Clin Exp Ophthalmol 240:202–208CrossRefPubMed
17.
go back to reference Tzekov RT, Gerth C, Werner JS (2004) Senescence of human multifocal electroretinogram components: a localized approach. Graefes Arch Clin Exp Ophthalmol 242:549–560CrossRefPubMed Tzekov RT, Gerth C, Werner JS (2004) Senescence of human multifocal electroretinogram components: a localized approach. Graefes Arch Clin Exp Ophthalmol 242:549–560CrossRefPubMed
18.
go back to reference Jackson GR, McGwin G Jr, Phillips JM et al (2004) Impact of aging and age-related maculopathy on activation of the a-wave of the rod-mediated electroretinogram. Invest Ophthalmol Vis Sci 45:3271–3278CrossRefPubMed Jackson GR, McGwin G Jr, Phillips JM et al (2004) Impact of aging and age-related maculopathy on activation of the a-wave of the rod-mediated electroretinogram. Invest Ophthalmol Vis Sci 45:3271–3278CrossRefPubMed
19.
go back to reference Hogg RE, Chakravarthy U (2006) Visual function and dysfunction in early and late age-related maculopathy. Prog Retin Eye Res 25:249–276CrossRefPubMed Hogg RE, Chakravarthy U (2006) Visual function and dysfunction in early and late age-related maculopathy. Prog Retin Eye Res 25:249–276CrossRefPubMed
20.
go back to reference Medeiros NE, Curcio CA (2001) Preservation of ganglion cell layer neurons in age-related macular degeneration. Invest Ophthalmol Vis Sci 42:795–803PubMed Medeiros NE, Curcio CA (2001) Preservation of ganglion cell layer neurons in age-related macular degeneration. Invest Ophthalmol Vis Sci 42:795–803PubMed
21.
go back to reference Curcio CA, Medeiros NE, Millican CL (1996) Photoreceptor loss in age-related macular degeneration. Invest Ophthalmol Vis Sci 37:1236–1249PubMed Curcio CA, Medeiros NE, Millican CL (1996) Photoreceptor loss in age-related macular degeneration. Invest Ophthalmol Vis Sci 37:1236–1249PubMed
22.
go back to reference Jackson GR, McGwin G Jr, Phillips JM et al (2006) Impact of aging and age-related maculopathy on inactivation of the a-wave of the rod-mediated electroretinogram. Vision Res 46:1422–1431CrossRefPubMed Jackson GR, McGwin G Jr, Phillips JM et al (2006) Impact of aging and age-related maculopathy on inactivation of the a-wave of the rod-mediated electroretinogram. Vision Res 46:1422–1431CrossRefPubMed
23.
go back to reference Feigl B, Brown B, Lovie-Kitchin J, Swann P (2005) Cone- and rod-mediated multifocal electroretinogram in early age-related maculopathy. Eye 19:431–441CrossRefPubMed Feigl B, Brown B, Lovie-Kitchin J, Swann P (2005) Cone- and rod-mediated multifocal electroretinogram in early age-related maculopathy. Eye 19:431–441CrossRefPubMed
24.
go back to reference Chen C, Wu L, Wu D et al (2004) The local cone and rod system function in early age-related macular degeneration. Doc Ophthalmol 109:1–8PubMed Chen C, Wu L, Wu D et al (2004) The local cone and rod system function in early age-related macular degeneration. Doc Ophthalmol 109:1–8PubMed
25.
go back to reference Ronan S, Nusinowitz S, Swaroop A, Heckenlively JR (2006) Senile panretinal cone dysfunction in age-related macular degeneration (AMD): a report of 52 AMD patients compared to age-matched controls. Trans Am Ophthalmol Soc 104:232–240PubMed Ronan S, Nusinowitz S, Swaroop A, Heckenlively JR (2006) Senile panretinal cone dysfunction in age-related macular degeneration (AMD): a report of 52 AMD patients compared to age-matched controls. Trans Am Ophthalmol Soc 104:232–240PubMed
26.
go back to reference Walter P, Widder RA, Luke C et al (1999) Electrophysiological abnormalities in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 237:962–968CrossRefPubMed Walter P, Widder RA, Luke C et al (1999) Electrophysiological abnormalities in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 237:962–968CrossRefPubMed
27.
go back to reference Sandberg MA, Miller S, Gaudio AR (1993) Foveal cone ERGs in fellow eyes of patients with unilateral neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 34:3477–3480PubMed Sandberg MA, Miller S, Gaudio AR (1993) Foveal cone ERGs in fellow eyes of patients with unilateral neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 34:3477–3480PubMed
28.
go back to reference Falsini B, Serrao S, Fadda A et al (1999) Focal electroretinograms and fundus appearance in nonexudative age-related macular degeneration. Quantitative relationship between retinal morphology and function. Graefes Arch Clin Exp Ophthalmol 237:193–200CrossRefPubMed Falsini B, Serrao S, Fadda A et al (1999) Focal electroretinograms and fundus appearance in nonexudative age-related macular degeneration. Quantitative relationship between retinal morphology and function. Graefes Arch Clin Exp Ophthalmol 237:193–200CrossRefPubMed
29.
go back to reference Gerth C, Hauser D, Delahunt PB et al (2003) Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen. Arch Ophthalmol 121:1404–1414CrossRefPubMed Gerth C, Hauser D, Delahunt PB et al (2003) Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen. Arch Ophthalmol 121:1404–1414CrossRefPubMed
30.
go back to reference Takiura K, Yuzawa M, Miyasaka S (2001) Multifocal electroretinogram in patients with soft drusen in the macula. Invest Ophthalmol Vis Sci 42:S73 Takiura K, Yuzawa M, Miyasaka S (2001) Multifocal electroretinogram in patients with soft drusen in the macula. Invest Ophthalmol Vis Sci 42:S73
31.
go back to reference Gerth C, Delahunt PB, Alam S et al (2006) Cone-mediated multifocal electroretinogram in age-related macular degeneration: progression over a long-term follow-up. Arch Ophthalmol 124:345–352CrossRefPubMed Gerth C, Delahunt PB, Alam S et al (2006) Cone-mediated multifocal electroretinogram in age-related macular degeneration: progression over a long-term follow-up. Arch Ophthalmol 124:345–352CrossRefPubMed
32.
go back to reference Jurklies B, Weismann M, Husing J et al (2002) Monitoring retinal function in neovascular maculopathy using multifocal electroretinography—early and long-term correlation with clinical findings. Graefes Arch Clin Exp Ophthalmol 240:244–264CrossRefPubMed Jurklies B, Weismann M, Husing J et al (2002) Monitoring retinal function in neovascular maculopathy using multifocal electroretinography—early and long-term correlation with clinical findings. Graefes Arch Clin Exp Ophthalmol 240:244–264CrossRefPubMed
33.
go back to reference Neveu MM, Tufail A, Dowler JG, Holder GE (2006) A comparison of pattern and multifocal electroretinography in the evaluation of age-related macular degeneration and its treatment with photodynamic therapy. Doc Ophthalmol 113:71–81CrossRefPubMed Neveu MM, Tufail A, Dowler JG, Holder GE (2006) A comparison of pattern and multifocal electroretinography in the evaluation of age-related macular degeneration and its treatment with photodynamic therapy. Doc Ophthalmol 113:71–81CrossRefPubMed
34.
go back to reference Bressler NM, Bressler SB, Haynes LA et al (2005) Verteporfin therapy for subfoveal choroidal neovascularization in age-related macular degeneration: four-year results of an open-label extension of 2 randomized clinical trials: TAP Report No. 7. Arch Ophthalmol 123:1283–1285 Bressler NM, Bressler SB, Haynes LA et al (2005) Verteporfin therapy for subfoveal choroidal neovascularization in age-related macular degeneration: four-year results of an open-label extension of 2 randomized clinical trials: TAP Report No. 7. Arch Ophthalmol 123:1283–1285
35.
go back to reference Tzekov R, Lin T, Zhang KM et al (2006) Ocular changes after photodynamic therapy. Invest Ophthalmol Vis Sci 47:377–385CrossRefPubMed Tzekov R, Lin T, Zhang KM et al (2006) Ocular changes after photodynamic therapy. Invest Ophthalmol Vis Sci 47:377–385CrossRefPubMed
36.
go back to reference Palmowski AM, Allgayer R, Heinemann-Vernaleken B, Ruprecht KW (2002) Influence of photodynamic therapy in choroidal neovascularization on focal retinal function assessed with the multifocal electroretinogram and perimetry. Ophthalmology 109:1788–1792CrossRefPubMed Palmowski AM, Allgayer R, Heinemann-Vernaleken B, Ruprecht KW (2002) Influence of photodynamic therapy in choroidal neovascularization on focal retinal function assessed with the multifocal electroretinogram and perimetry. Ophthalmology 109:1788–1792CrossRefPubMed
37.
go back to reference Moschos MM, Panayotidis D, Theodossiadis G, Moschos M (2004) Assessment of macular function by multifocal electroretinogram in age-related macular degeneration before and after photodynamic therapy. J Fr Ophtalmol 27:1001–1006CrossRefPubMed Moschos MM, Panayotidis D, Theodossiadis G, Moschos M (2004) Assessment of macular function by multifocal electroretinogram in age-related macular degeneration before and after photodynamic therapy. J Fr Ophtalmol 27:1001–1006CrossRefPubMed
38.
go back to reference Ruther K, Breidenbach K, Schwartz R et al (2003) [Testing central retinal function with multifocal electroretinography before and after photodynamic therapy]. Ophthalmologe 100:459–464PubMed Ruther K, Breidenbach K, Schwartz R et al (2003) [Testing central retinal function with multifocal electroretinography before and after photodynamic therapy]. Ophthalmologe 100:459–464PubMed
39.
go back to reference Mackay AM, Brown MC, Grierson I, Harding SP (2008) Multifocal electroretinography as a predictor of maintenance of vision after photodynamic therapy for neovascular age-related macular degeneration. Doc Ophthalmol 116:13–18CrossRefPubMed Mackay AM, Brown MC, Grierson I, Harding SP (2008) Multifocal electroretinography as a predictor of maintenance of vision after photodynamic therapy for neovascular age-related macular degeneration. Doc Ophthalmol 116:13–18CrossRefPubMed
40.
go back to reference Oner A, Karakucuk S, Mirza E, Erkilic K (2005) The changes of pattern electroretinography at the early stage of photodynamic therapy. Doc Ophthalmol 111:107–112CrossRefPubMed Oner A, Karakucuk S, Mirza E, Erkilic K (2005) The changes of pattern electroretinography at the early stage of photodynamic therapy. Doc Ophthalmol 111:107–112CrossRefPubMed
41.
go back to reference Shahar J, Avery RL, Heilweil G et al (2006) Electrophysiologic and retinal penetration studies following intravitreal injection of bevacizumab (Avastin). Retina 26:262–269CrossRefPubMed Shahar J, Avery RL, Heilweil G et al (2006) Electrophysiologic and retinal penetration studies following intravitreal injection of bevacizumab (Avastin). Retina 26:262–269CrossRefPubMed
42.
go back to reference Manzano RP, Peyman GA, Khan P, Kivilcim M (2006) Testing intravitreal toxicity of bevacizumab (Avastin). Retina 26:257–261CrossRefPubMed Manzano RP, Peyman GA, Khan P, Kivilcim M (2006) Testing intravitreal toxicity of bevacizumab (Avastin). Retina 26:257–261CrossRefPubMed
43.
go back to reference Heiduschka P, Julien S, Hofmeister S et al (2008) Bevacizumab (Avastin) does not harm retinal function after intravitreal injection as shown by electroretinography in adult mice. Retina 28:46–55PubMedCrossRef Heiduschka P, Julien S, Hofmeister S et al (2008) Bevacizumab (Avastin) does not harm retinal function after intravitreal injection as shown by electroretinography in adult mice. Retina 28:46–55PubMedCrossRef
44.
go back to reference Maturi RK, Bleau LA, Wilson DL (2006) Electrophysiologic findings after intravitreal bevacizumab (Avastin) treatment. Retina 26:270–274CrossRefPubMed Maturi RK, Bleau LA, Wilson DL (2006) Electrophysiologic findings after intravitreal bevacizumab (Avastin) treatment. Retina 26:270–274CrossRefPubMed
45.
go back to reference Moschos MM, Brouzas D, Apostolopoulos M et al (2007) Intravitreal use of bevacizumab (Avastin) for choroidal neovascularization due to ARMD: a preliminary multifocal-ERG and OCT study. Multifocal-ERG after use of bevacizumab in ARMD. Doc Ophthalmol 114:37–44CrossRefPubMed Moschos MM, Brouzas D, Apostolopoulos M et al (2007) Intravitreal use of bevacizumab (Avastin) for choroidal neovascularization due to ARMD: a preliminary multifocal-ERG and OCT study. Multifocal-ERG after use of bevacizumab in ARMD. Doc Ophthalmol 114:37–44CrossRefPubMed
46.
go back to reference Luke C, Aisenbrey S, Luke M et al (2001) Electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in age related macular degeneration. Br J Ophthalmol 85:928–932CrossRefPubMed Luke C, Aisenbrey S, Luke M et al (2001) Electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in age related macular degeneration. Br J Ophthalmol 85:928–932CrossRefPubMed
47.
go back to reference Terasaki H, Miyake Y, Suzuki T et al (2002) Change in full-field ERGs after macular translocation surgery with 360 degrees retinotomy. Invest Ophthalmol Vis Sci 43:452–457PubMed Terasaki H, Miyake Y, Suzuki T et al (2002) Change in full-field ERGs after macular translocation surgery with 360 degrees retinotomy. Invest Ophthalmol Vis Sci 43:452–457PubMed
48.
go back to reference Terasaki H, Ishikawa K, Niwa Y et al (2004) Changes in focal macular ERGs after macular translocation surgery with 360 degrees retinotomy. Invest Ophthalmol Vis Sci 45:567–573CrossRefPubMed Terasaki H, Ishikawa K, Niwa Y et al (2004) Changes in focal macular ERGs after macular translocation surgery with 360 degrees retinotomy. Invest Ophthalmol Vis Sci 45:567–573CrossRefPubMed
49.
go back to reference Owsley C, Jackson GR, Cideciyan AV et al (2000) Psychophysical evidence for rod vulnerability in age-related macular degeneration. Invest Ophthalmol Vis Sci 41:267–273PubMed Owsley C, Jackson GR, Cideciyan AV et al (2000) Psychophysical evidence for rod vulnerability in age-related macular degeneration. Invest Ophthalmol Vis Sci 41:267–273PubMed
50.
go back to reference Feigl B, Brown B, Lovie-Kitchin J, Swann P (2006) The rod-mediated multifocal electroretinogram in aging and in early age-related maculopathy. Curr Eye Res 31:635–644CrossRefPubMed Feigl B, Brown B, Lovie-Kitchin J, Swann P (2006) The rod-mediated multifocal electroretinogram in aging and in early age-related maculopathy. Curr Eye Res 31:635–644CrossRefPubMed
51.
go back to reference Sutter EE, Tran D (1992) The field topography of ERG components in man–I. The photopic luminance response. Vision Res 32:433–446CrossRefPubMed Sutter EE, Tran D (1992) The field topography of ERG components in man–I. The photopic luminance response. Vision Res 32:433–446CrossRefPubMed
52.
go back to reference Sutter EE (1991) The fast m-transform: a fast computation of cross-correlations with binary m-sequences. Soc Indust Appl Math 20:686–694 Sutter EE (1991) The fast m-transform: a fast computation of cross-correlations with binary m-sequences. Soc Indust Appl Math 20:686–694
53.
go back to reference Hood DC, Li J (1997) A technique for measuring individual multifocal ERG records. Opt Soc Am Trends Opt Photonics 11:33–41 Hood DC, Li J (1997) A technique for measuring individual multifocal ERG records. Opt Soc Am Trends Opt Photonics 11:33–41
54.
go back to reference Hood DC, Bach M, Brigell M et al (2008) ISCEV guidelines for clinical multifocal electroretinography (2007 edition). Doc Ophthalmol 116:1–11CrossRefPubMed Hood DC, Bach M, Brigell M et al (2008) ISCEV guidelines for clinical multifocal electroretinography (2007 edition). Doc Ophthalmol 116:1–11CrossRefPubMed
Metadata
Title
The role of the ERG in the diagnosis and treatment of Age-Related Macular Degeneration
Author
Christina Gerth
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Documenta Ophthalmologica / Issue 1/2009
Print ISSN: 0012-4486
Electronic ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-008-9133-x

Other articles of this Issue 1/2009

Documenta Ophthalmologica 1/2009 Go to the issue

Acknowledgments

List of reviewers