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Electroretinographic Findings in Iris Neovascularization due to Acute Central Retinal Vein Occlusion

Electroretinographic Findings in Iris Neovascularization due to Acute Central Retinal Vein Occlusion Abstract • Electroretinograms (ERGs) were recorded in 94 patients with central retinal vein occlusion (CRVO). Of these 94, 11 had neovascularization of the iris (NVI) at the time of testing, 25 later developed NVI, and 58 did not develop NVI during a follow-up period that varied from 1½ to 5 years. The ERG recorded at the patient's presentation visit predicted the occurrence of NVI in these patients with high sensitivity and specificity. The most predictive ERG parameters were the semi-saturation constant from intensityresponse analysis (log K), and the implicit times of the scotopic a- and b-waves and the scotopic 30-Hz flicker response. These parameters were highly correlated, suggesting that the functional mechanism that places eyes at risk for NVI in CRVO is unidimensional. Paradoxically, the most likely candidate for this mechanism is photoreceptor sensitivity loss due to ischemia. References 1. Clarkson JC. Central retinal vein occlusion . In: Ryan SJ, ed. Retina . St Louis, Mo: Mosby-Year Book; 1989;2:421-426. 2. Hayreh S, Rojas P, Podhajsky P, Montague CRA, Woolson RF. Ocular neovascularization with retinal vascular occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Ophthalmology . 1983;90:488-506.Crossref 3. Magargal LE, Donoso LA, Sanborn GE. Retinal ischemia and risk of neovascularization following central retinal vein obstruction . Ophthalmology . 1982;89:1241-1245.Crossref 4. Laatikainen L, Kohner EM, Khoury D, Blach RK. Panretinal photocoagulation in central retinal vein occlusion: a randomised controlled clinical study . Br J Ophthalmol . 1977;61:741-753.Crossref 5. Karpe G. The basis of clinical electroretinography . Acta Ophthalmol Suppl . 1945;24:1-118. 6. Karpe G. Clinical electroretinography . Trans Ophthalmol Soc U K . 1949;69:237-247. 7. Henkes HE. Electroretinography in circulatory disturbances of the retina, I: electroretinogram in cases of occlusion of the central retinal vein or one of its branches . Arch Ophthalmol . 1953;49:190-201.Crossref 8. Karpe G, Uchermann A. The clinical electroretinogram, IV: the electroretinogram in circulatory disturbances of the retina . Acta Ophthalmol . 1955;33:493-516.Crossref 9. Vannas S. Electroretinographic observations in central vein occlusion . Acta Ophthalmol . 1960;38:312-321.Crossref 10. Karpe G, Germanis M. The prognostic value of the electroretinogram in thrombosis of the retinal veins . Acta Ophthalmol Suppl . 1962;70:202-229. 11. Sabates R, Hirose T, McMeel JW. Electroretinography in the prognosis and classification of central retinal vein occlusion . Arch Ophthalmol . 1983;101:232-235.Crossref 12. Johnson MA, Marcus S, Elman MJ, McPhee TJ. Neovascularization in central retinal vein occlusion: electroretinographic findings . Arch Ophthalmol . 1988;106:348-352.Crossref 13. Kaye SB, Harding SP. Early electroretinography in unilateral central retinal vein occlusion as a predictor of rubeosis iridis . Arch Ophthalmol . 1988;106:353-356.Crossref 14. Breton ME, Quinn GE, Keene SS, Dahmen JC, Brucker AJ. Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients . Ophthalmology . 1989;96:1343-1352.Crossref 15. Johnson MA. Use of electroretinographic ratios in assessment of vascular occlusion and ischemia . In: Heckenlively J, Arden G, eds. Principles and Practice of Clinical Electrophysiology of Vision . St Louis, Mo: Mosby-Year Book; 1991:613-618. 16. Welch JC, Augsburger JJ. Assessment of angiographic retinal capillary nonperfusion in central retinal vein occlusion . Am J Ophthalmol . 1987;103:761-766. 17. Lawwill T. Should an electroretinogram be obtained for patients with vein occlusion? Arch Ophthalmol . 1991;109:480.Crossref 18. Johnson MA, Massof RW. The photomyoclonic reflex: an artifact in the clinical electroretinogram . Br J Ophthalmol . 1982;66:368-378.Crossref 19. Peachey NS, Alexander KR, Fishman GA. The luminance-response function of the dark-adapted human electroretinogram . Vision Res . 1987;29:263-270.Crossref 20. Severns ML, Johnson MA. The care and fitting of ERG Naka-Rushton functions. Doc Ophthalmol. In press. 21. Severns ML, Johnson MA, Merritt SA. Automated estimation of latency and amplitude from the flicker electroretinogram . Appl Optics . 1991;30:2106-2112.Crossref 22. Green DM, Swets JA. Signal Detection Theory and Psychophysics . Melbourne, Fla: Robert E Krieger Publishing Co Inc; 1974:45-49. 23. Quinlan PM, Johnson MA, Hiner CJ, Elman MJ. Fluorescein angiography and electroretinography as predictors of neovascularization in CRVO . Invest Ophthalmol Vis Sci Suppl . 1989;30:392. 24. Johnson MA, Procope J, Quinlan PM. Electroretinographic oscillatory potentials and their role in predicting treatable complications in patients with central retinal vein occlusion . Optical Soc Am Tech Digest . 1990;3:62-65. 25. Sakaue H, Katsumi O, Hirose T. Electroretinographic findings in fellow eyes of patients with central retinal vein occlusion . Arch Ophthalmol . 1989;107:1459-1462.Crossref 26. Johnson MA, Severns ML, Kelman SE. Use of a neural network to analyze ERG parameters in central retinal vein occlusion . Invest Ophthalmol Vis Sci Suppl . 1990;31:568. 27. Johnson MA, Severns ML, Kelman SE. Using a neural network and the electroretinogram to classify central retinal vein occlusion . Perception . 1990;19:367. 28. Johnson MA, Hood DC. A theoretical interpretation of ERG abnormalities in central retinal vein occlusion . Optical Soc Am Tech Digest . 1988;3:84-87. 29. Johnson MA, Massof RW. Photoreceptor sensitivity loss in patients with central retinal vein occlusion and iris neovascularization . Invest Ophthalmol Vis Sci Suppl . 1988;29:179. 30. Hood DC, Birch DG. A computational model of the amplitude and implicit time of the b-wave of the human ERG . Vis Neurosci . 1992;8:107-126.Crossref 31. Roecker EB, Pulos E, Bresnick GH, Severns M. Characterization of the electroretinographic scotopic b-wave amplitude in diabetic and normal subjects . Invest Ophthalmol Vis Sci . 1992;33:1575-1583. 32. Hayreh S. Chronic ocular ischemic syndrome in internal carotid artery occlusive disease: controversy on 'venous stasis retinopathy.' In: Amaurosis Fugax . New York, NY: Springer-Verlag NY Inc; 1988:135-158. 33. Wolf S, Bertram B, Jung F, Kiesewetter H, Teping C, Reim M. Videofluoreszenzangiographische Verlaufsbeobachtungen bei Patienten mit retinalem Stase-Syndrom . Klin Monatsbl Augenheilkd . 1988;193:39-43.Crossref 34. Johnson MA. B/A-wave amplitude ratios in retinal vascular disease . In: Heckenlively J, Arden G, eds. Principles and Practice of Clinical Electrophysiology of Vision . St Louis, Mo: Mosby-Year Book; 1991:531-536. 35. Breton ME, Schueller BS, Montzka DP. Electroretinogram b-wave implicit time and b/a wave ratio as a function of intensity in central retinal vein occlusion . Ophthalmology . 1991;98:1845-1853.Crossref 36. Johnson MA, Marcus S, Elman MJ. ERG sensitivity loss in venous stasis retinopathy . Invest Ophthalmol Vis Sci Suppl . 1987;28:319. 37. Kearns TP, Hollenhorst RW. Venous-stasis retinopathy of occlusive disease of the carotid artery . Proc Staff Meet Mayo Clin . 1963;38:304-312. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Electroretinographic Findings in Iris Neovascularization due to Acute Central Retinal Vein Occlusion

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1993.01090060094030
Publisher site
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Abstract

Abstract • Electroretinograms (ERGs) were recorded in 94 patients with central retinal vein occlusion (CRVO). Of these 94, 11 had neovascularization of the iris (NVI) at the time of testing, 25 later developed NVI, and 58 did not develop NVI during a follow-up period that varied from 1½ to 5 years. The ERG recorded at the patient's presentation visit predicted the occurrence of NVI in these patients with high sensitivity and specificity. The most predictive ERG parameters were the semi-saturation constant from intensityresponse analysis (log K), and the implicit times of the scotopic a- and b-waves and the scotopic 30-Hz flicker response. These parameters were highly correlated, suggesting that the functional mechanism that places eyes at risk for NVI in CRVO is unidimensional. Paradoxically, the most likely candidate for this mechanism is photoreceptor sensitivity loss due to ischemia. References 1. Clarkson JC. Central retinal vein occlusion . In: Ryan SJ, ed. Retina . St Louis, Mo: Mosby-Year Book; 1989;2:421-426. 2. Hayreh S, Rojas P, Podhajsky P, Montague CRA, Woolson RF. Ocular neovascularization with retinal vascular occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Ophthalmology . 1983;90:488-506.Crossref 3. Magargal LE, Donoso LA, Sanborn GE. Retinal ischemia and risk of neovascularization following central retinal vein obstruction . Ophthalmology . 1982;89:1241-1245.Crossref 4. Laatikainen L, Kohner EM, Khoury D, Blach RK. Panretinal photocoagulation in central retinal vein occlusion: a randomised controlled clinical study . Br J Ophthalmol . 1977;61:741-753.Crossref 5. Karpe G. The basis of clinical electroretinography . Acta Ophthalmol Suppl . 1945;24:1-118. 6. Karpe G. Clinical electroretinography . Trans Ophthalmol Soc U K . 1949;69:237-247. 7. Henkes HE. Electroretinography in circulatory disturbances of the retina, I: electroretinogram in cases of occlusion of the central retinal vein or one of its branches . Arch Ophthalmol . 1953;49:190-201.Crossref 8. Karpe G, Uchermann A. The clinical electroretinogram, IV: the electroretinogram in circulatory disturbances of the retina . Acta Ophthalmol . 1955;33:493-516.Crossref 9. Vannas S. Electroretinographic observations in central vein occlusion . Acta Ophthalmol . 1960;38:312-321.Crossref 10. Karpe G, Germanis M. The prognostic value of the electroretinogram in thrombosis of the retinal veins . Acta Ophthalmol Suppl . 1962;70:202-229. 11. Sabates R, Hirose T, McMeel JW. Electroretinography in the prognosis and classification of central retinal vein occlusion . Arch Ophthalmol . 1983;101:232-235.Crossref 12. Johnson MA, Marcus S, Elman MJ, McPhee TJ. Neovascularization in central retinal vein occlusion: electroretinographic findings . Arch Ophthalmol . 1988;106:348-352.Crossref 13. Kaye SB, Harding SP. Early electroretinography in unilateral central retinal vein occlusion as a predictor of rubeosis iridis . Arch Ophthalmol . 1988;106:353-356.Crossref 14. Breton ME, Quinn GE, Keene SS, Dahmen JC, Brucker AJ. Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients . Ophthalmology . 1989;96:1343-1352.Crossref 15. Johnson MA. Use of electroretinographic ratios in assessment of vascular occlusion and ischemia . In: Heckenlively J, Arden G, eds. Principles and Practice of Clinical Electrophysiology of Vision . St Louis, Mo: Mosby-Year Book; 1991:613-618. 16. Welch JC, Augsburger JJ. Assessment of angiographic retinal capillary nonperfusion in central retinal vein occlusion . Am J Ophthalmol . 1987;103:761-766. 17. Lawwill T. Should an electroretinogram be obtained for patients with vein occlusion? Arch Ophthalmol . 1991;109:480.Crossref 18. Johnson MA, Massof RW. The photomyoclonic reflex: an artifact in the clinical electroretinogram . Br J Ophthalmol . 1982;66:368-378.Crossref 19. Peachey NS, Alexander KR, Fishman GA. The luminance-response function of the dark-adapted human electroretinogram . Vision Res . 1987;29:263-270.Crossref 20. Severns ML, Johnson MA. The care and fitting of ERG Naka-Rushton functions. Doc Ophthalmol. In press. 21. Severns ML, Johnson MA, Merritt SA. Automated estimation of latency and amplitude from the flicker electroretinogram . Appl Optics . 1991;30:2106-2112.Crossref 22. Green DM, Swets JA. Signal Detection Theory and Psychophysics . Melbourne, Fla: Robert E Krieger Publishing Co Inc; 1974:45-49. 23. Quinlan PM, Johnson MA, Hiner CJ, Elman MJ. Fluorescein angiography and electroretinography as predictors of neovascularization in CRVO . Invest Ophthalmol Vis Sci Suppl . 1989;30:392. 24. Johnson MA, Procope J, Quinlan PM. Electroretinographic oscillatory potentials and their role in predicting treatable complications in patients with central retinal vein occlusion . Optical Soc Am Tech Digest . 1990;3:62-65. 25. Sakaue H, Katsumi O, Hirose T. Electroretinographic findings in fellow eyes of patients with central retinal vein occlusion . Arch Ophthalmol . 1989;107:1459-1462.Crossref 26. Johnson MA, Severns ML, Kelman SE. Use of a neural network to analyze ERG parameters in central retinal vein occlusion . Invest Ophthalmol Vis Sci Suppl . 1990;31:568. 27. Johnson MA, Severns ML, Kelman SE. Using a neural network and the electroretinogram to classify central retinal vein occlusion . Perception . 1990;19:367. 28. Johnson MA, Hood DC. A theoretical interpretation of ERG abnormalities in central retinal vein occlusion . Optical Soc Am Tech Digest . 1988;3:84-87. 29. Johnson MA, Massof RW. Photoreceptor sensitivity loss in patients with central retinal vein occlusion and iris neovascularization . Invest Ophthalmol Vis Sci Suppl . 1988;29:179. 30. Hood DC, Birch DG. A computational model of the amplitude and implicit time of the b-wave of the human ERG . Vis Neurosci . 1992;8:107-126.Crossref 31. Roecker EB, Pulos E, Bresnick GH, Severns M. Characterization of the electroretinographic scotopic b-wave amplitude in diabetic and normal subjects . Invest Ophthalmol Vis Sci . 1992;33:1575-1583. 32. Hayreh S. Chronic ocular ischemic syndrome in internal carotid artery occlusive disease: controversy on 'venous stasis retinopathy.' In: Amaurosis Fugax . New York, NY: Springer-Verlag NY Inc; 1988:135-158. 33. Wolf S, Bertram B, Jung F, Kiesewetter H, Teping C, Reim M. Videofluoreszenzangiographische Verlaufsbeobachtungen bei Patienten mit retinalem Stase-Syndrom . Klin Monatsbl Augenheilkd . 1988;193:39-43.Crossref 34. Johnson MA. B/A-wave amplitude ratios in retinal vascular disease . In: Heckenlively J, Arden G, eds. Principles and Practice of Clinical Electrophysiology of Vision . St Louis, Mo: Mosby-Year Book; 1991:531-536. 35. Breton ME, Schueller BS, Montzka DP. Electroretinogram b-wave implicit time and b/a wave ratio as a function of intensity in central retinal vein occlusion . Ophthalmology . 1991;98:1845-1853.Crossref 36. Johnson MA, Marcus S, Elman MJ. ERG sensitivity loss in venous stasis retinopathy . Invest Ophthalmol Vis Sci Suppl . 1987;28:319. 37. Kearns TP, Hollenhorst RW. Venous-stasis retinopathy of occlusive disease of the carotid artery . Proc Staff Meet Mayo Clin . 1963;38:304-312.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1993

References

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