Journal
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE
Volume 55, Issue 3, Pages 1332-1338Publisher
ASSOC RESEARCH VISION OPHTHALMOLOGY INC
DOI: 10.1167/iovs.13-12657
Keywords
low vision; visual function; vision regeneration; retinitis pigmentosa; electroretinography
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Funding
- Australian Research Council (ARC) through its Special Research Initiative (SRI) in Bionic Vision Science and Technology
- NHMRC [529905]
- Victorian Government
- NHMRC Centre for Clinical Research Excellence Award [529923]
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PURPOSE. Vision restoration is a fast-approaching reality for some people with profound vision loss. In order to reliably determine treatment efficacy, accurate assessment of baseline residual visual function is critical. The purpose of this study was to compare residual function as detected on Goldman visual field (GVF) and full-field ERG (ffERG), and correlate with the remaining photoreceptor layer as determined by spectral-domain optical coherence tomography (SD-OCT), in subjects with severe vision loss. METHODS. Fifty-four subjects with advanced retinitis pigmentosa and no discernible signal on ffERG were included. Trace residual function was assessed using discrete Fourier transform (DFT) analysis of the 30-Hz flicker ffERG and the percentage of remaining GVF. The horizontal extent of the outer nuclear layer (ONL) on SD-OCT was assessed. RESULTS. Thirty percent of the study eyes had a 30-Hz flicker response after DFT analysis of the ffERG, and 57% had a measurable GVF. Thirty-five percent had a visible ONL on SD-OCT. There was no significant correlation between the magnitude of the 30-Hz flicker response and the percentage of remaining GVF (r = 0.172, P = 0.213) or the extent of remaining central photoreceptors (r = 0.258, P = 0.06). Only 17% of the eyes had all three parameters detected. CONCLUSIONS. Discrete Fourier transform analysis of the 30Hz-flicker ffERG response and GVF can detect trace residual function. Evidence of this residual function is not always supported by the structural correlate of a measurable ONL. Our findings highlight the importance of completing a multimodal assessment to accurately define the important parameters of retinal structure and function in people with profound vision loss.
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