Characteristics Of Full-field Electroretinography In Vogt-Koyanagi-Harada Disease

Purpose:To investigate the dynamic changes of full-field electroretinography in Vogt-Koyanagi-Harada disease and its clinical application value.Methods:A total of 42 consecutive patients with Vogt-Koyanagi-Harada(VKH)disease were selected as the experimental group(84 eyes)for the first time in the ophthalmology clinic of the First Affiliated Hospital of Chongqing Medical University from December 24 to June 26.All of the patients were referred to our department within two months of onset and all showed acute uveitis.Moreover,45 healthy volunteers with sex and age-matched were included as a control group(eyes).Full-field electroretinography(ffERG)examination was performed on the experimental group and the control group according to the ISCEV standard.Dynamic changes in retinal function were evaluated by recording ffERG data of patients before,2 months after,6 months after,and2 months after systemic administration of glucocorticoids in combination with cyclosporine.The relationship between ffERG and structural changes revealed by B ultrasound,fluorescein fundus angiography(FFA),indocyanine green angiography(ICGA)and optical coherence tomography(OCT)was also evaluated.The generalized linear mixed model(GLMM)was used to analyze repeated measurement data of ffERG during follow-up.A mixed linear regression model was used to analyze the difference between the patients and the control group.The difference of clinical manifestations between before and after treatment was analyzed by x~2 test.P<.5 indicates statistical significance.Results:Before treatment,all patients showed obvious visual acuity and retinal structural changes.These changes were significantly improved 2months after treatment,and there were no obvious abnormalities after 6months of treatment.Before treatment,the amplitude of all dark-adapted(DA)and light-adapted(LA)responses of ffERG in patients were significantly reduced,and the latency period was prolonged.After 2months of treatment,except for the amplitude of a wave in dark adaptation response,the remaining parameters were improved.After2 months of treatment,all the parameters of the patients'ffERG were not statistically different from the normal group(P>.5).Conclusions:1.The functional recovery of the retina with FfERG response lags behind that of the structural recovery,which we believe is due to greater sensitivity in measuring retinal function.2.Both the inner and outer retinas of VKH disease have dysfunction.3.The inner retinal dysfunction is lighter than the outer retinal dysfunction,and the inner retinal dysfunction recovers earlier in VKH syndrome.4.FfERG can be used as a method to monitor the effect of treatment,help to decide when to terminate treatment,and also support VKH disease to restore normal retinal function after regular and effective treatment.