J Korean Ophthalmol Soc > Volume 58(3); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(3):305-312.
DOI: https://doi.org/10.3341/jkos.2017.58.3.305    Published online March 15, 2017.
Simultaneous Recording of Flash Electroretinography and Visual Evoked Potential in Vitreous Hemorrhage with Diabetic Retinopathy.
Yoon Kyung Kim, Hoon Dong Kim, Tae Kwann Park, Young Hoon Ohn
1Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. yhohn@schmc.ac.kr
2Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
당뇨망막병증에 의한 유리체출혈에서 동시에 기록된 명순응 망막전위도와 섬광 시유발전위 검사
김윤경1⋅김훈동2⋅박태관1⋅온영훈1
순천향대학교 의과대학 부천병원 안과학교실1, 순천향대학교 의과대학 천안병원 안과학교실2
Correspondence:  Young-Hoon Ohn, MD, PhD
Email: yhohn@schmc.ac.kr
Received: 7 April 2016   • Revised: 16 June 2016   • Accepted: 16 February 2017
Abstract
PURPOSE
To determine whether the simultaneous recording of photopic electroretinography (ERG) and flash visual evoked potential (VEP) can predict the postoperative outcome in diabetic cases where massive vitreous hemorrhage precludes fundus observation. METHODS: The photopic ERG and flash VEP were recorded simultaneously on 20 eyes of 20 normal subjects, and 23 eyes of 23 patients who were diagnosed with Grade IV vitreous hemorrhage d/t diabetic retinopathy. Of the 23 patients, fellow eyes were diagnosed with proliferative diabetic retinopathy and they underwent pars plana vitrectomy after the test. Three groups were analyzed the responses of photopic ERG and flash VEP. Best corrected visual acuity was also checked before and after the surgery. After the 8 weeks after the vitrectomy, two groups were formed, based on the outcome of surgery and these two groups were analyzed the preoperative response of photopic ERG and flash VEP. RESULTS: When comparing the groups between proliferative diabetic retinopathy and normal eyes, Grade IV vitreous hemorrhage and fellow eyes, there was a statistically significant (p < 0.05) difference in a wave amplitude, a wave implicit time, b wave amplitude, b wave implicit time of photopic ERG and P2 peak time of flash VEP. In addition, a wave amplitude of photopic ERG showed the best predictive ability (area under receiver operating characteristic [AUROC] curve value of 0.88) when comparing improved visual acuity group to the unimproved visual acuity group. CONCLUSIONS: Simultaneous recordings of photopic ERG and flash VEP showed the decreased function of retina and optic pathway on eyes with vitreous hemorrhage precluding inspection of the fundus. In addition, preoperative photopic ERG and flash VEP can safely predict the outcome of vitrectomy in dense vitreous hemorrhage of diabetics.
Key Words: Diabetic retinopathy;Electroretinography;Simultaneous recordings;Visual evoked potentials;Vitreous hemorrhage


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