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  • ISSN: 2333-7117
    Special Issue entitled: The Biology of Retinal Photoreceptor Cells
    Seifollah Azadi
    Assistant Professor of Research
    University of Oklahoma Health Sciences Center
    Oklahoma City
    USA
    Research Article
    Nicola Pescosolido1, Stefano Fazio2 and Dario Rusciano3*
    Abstract: Flicker ERG represents an objective method to evaluate photoreceptors functional state. Aim of the present work was to assess which of its two parameters - implicit time or amplitude - could better discriminate between normal and pathologic subjects affected by different types of retinopathies.
    Two groups of patients were enrolled. The first group included 34 eyes of 17 patients with no eye pathologies; the second group included 23 eyes of 12 patients with different retinopathies. The Retimax Advanced Plus® was used to generate a flash, the intensity of which was calibrated according to the ISCEV standard. Both the implicit time and the amplitude of the flicker ERG B wave were recorded, and related to the pathological state of the retina.
    The average value of the amplitude was significantly decreased in retinopathic patients (29.42 ± 12.05 mV) with respect to normal patients (53.57 ± 19.24 mV), however with a high variability and a wide zone of overlapping between normal and pathologic patients. Implicit time values had a much lower variability, with no overlapping between the two groups of patients: average normal values were 31.70 ± 1.40 ms for healthy patients and 39.48 ± 2.13 ms for retinopathic patients.
    Our results indicate that the implicit time value of the flicker ERG B-wave can be a quantifiable objective measurement of photoreceptor damage in different types of retinal diseases. Therefore, it can be a valuable alternative for their diagnosis and follow up, which nowadays is still mainly based on morphologic criteria.
    Sandeep Saxena1*, Nibha Mishra1, Vinay Khanna2#, Astha Jain1, Rajendra Shukla2 and Carsten H. Meyer3
    Abstract: Consecutive cases of type 2 diabetes mellitus in the 40-65 age group were included to study the association of serum N-CML, VEGF and ICAM-1 with photoreceptor inner segment ellipsoid disruption in diabetic retinopathy. Study subjects included patients with type 2 DM [diabetes mellitus with no retinopathy (No DR; n=40); non- proliferative diabetic retinopathy (NPDR; n=39); proliferative diabetic retinopathy (PDR; n=39)] and healthy controls (n=39) between the ages of 40 and 65 years. Disruption of photoreceptor inner segment ellipsoid (ISel)was graded by spectral domain optical coherence tomography. The serum levels of N-CML, VEGF and ICAM-1were analyzed using the standard protocol. Data was statistically analyzed. A significant difference was found between the serum levels of N-CML, VEGF and ICAM-1 and the various study groups (p<0.001). A positive correlation was found between the photoreceptor ISel disruption and the levels of N-CML (r=0.68, p<0.0001), VEGF (r=0.36, p=0.001) and ICAM-1 (r=0.36, p=0.001). A significant positive correlation was found between log MAR visual acuity and grade of disruption (r=0.9, p<0.0001).Present study highlighted the positive correlation of N-CML, VEGF and ICAM-1 with photoreceptor structural integrity and visual acuity in diabetic retinopathy providing further insight into the pathogenesis of the disease. Thus serum N-CML, VEGF and ICAM-1levels can be used as prognosticator of photoreceptor disruption in diabetic retinopathy.
    Case Report
    Nicola Pescosolido1, Stefano Fazio2 and Dario Rusciano3*
    Abstract: Aim of the present work has been to evaluate the effects in both the treated and the contra lateral eye of mono-lateral intra vitreal treatment with Ranibizumab (LUCENTIS®) in a 46-year-old woman affected by bilateral myopic choroidal neovascularization.
    A 46-year-old woman presented a best-corrected visual acuity of 8/10 in the right eye, and 1/20 in the left eye. Fundus examination revealed a bilateral myopic choroiditis and a foveal neovascularization in the left eye that was confirmed by OCT analysis. The flicker ERG response was also altered in both eyes.
    The subretinal neovascularization in the left eye was treated by an intravitreal injection of ranibizumab. After 8 days the OCT and the flicker ERG showed no improvement, and a second injection of ranibizumab was given one month after the first. Twenty days later OCT and flicker ERG showed a significant improvement both in the left, treated eye, but also in the right, untreated eye.
    In conclusion, ranibizumab apparently inhibited VEGF induction of new vessel formation and the following edema due to the leakiness of these new vessels and the rupture of the blood-retinal barrier in the treated eye. Evidently, it also diffused via the hematic and/or neuronal route to the contralateral eye where it also exerted a detectable improvement of the local conditions.
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