Electrophysiological and clinical tests in dry age-related macular degeneration follow-up: differences between mfERG and OCT.

BACKGROUND: Age-related macular degeneration (AMD) is one of the major causes of progressive and debilitating visual impairment in developed countries and has become a growing health and social issue that needs to be addressed. Imaging techniques and functional tests are useful to assess the degree of macular dysfunction and AMD progression. However, given the slow progression of the disease, it is necessary to identify which techniques are more sensitive for the diagnosis and monitoring of patients with AMD.

PURPOSE: To study changes observed with both imaging techniques and electrophysiological tests in dry AMD-diagnosed patients during 2 years in order to identify the most sensitive technique.

METHODS: Fundus photography, OCT (macular thickness and number of drusen), Pattern VEP (P100 wave), Pattern ERG (P50 wave) and multifocal ERG (central rings) were carried out in 30 patients that were diagnosed with dry AMD in both eyes. The tests were repeated 1 and 2 years later.

RESULTS: No statistically significant changes were observed in visual acuity or in the severity of the disease throughout the study. OCT showed an increase in the number of drusen, as well as in macular thickness. As for the electrophysiological techniques, no significant changes were observed throughout the study in Pattern VEP or Pattern ERG. mfERG showed significant alterations. Statistical analysis showed that mfERG is more efficient in detecting changes throughout the experimental period.

CONCLUSIONS: OCT and mfERG are useful in the diagnosis and monitoring of dry AMD patients, whilst mfERG is the most sensitive technique to study the progression of this disease in short periods of time.