Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)

Purpose The evaluation of the effect of UVA radiation on the photoreceptors after CXL. Methods Seventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 a...

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Veröffentlicht in:Acta ophthalmologica (Oxford, England) England), 2017-09, Vol.95 (S259), p.n/a
Hauptverfasser: Lazaridis, A., Tsamassiotis, S., Besgen, V., Sekundo, W., Wenner, Y., Droutsas, K.
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container_title Acta ophthalmologica (Oxford, England)
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Tsamassiotis, S.
Besgen, V.
Sekundo, W.
Wenner, Y.
Droutsas, K.
description Purpose The evaluation of the effect of UVA radiation on the photoreceptors after CXL. Methods Seventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 and 6 weeks postoperatively with mf‐ERG and OCT. The P1 amplitude of the photoreceptor response was documented in 4 concentric rings, with ring 1 (R1) representing the foveal response and rings 2–4 (R2‐R4) corresponding to the successive annuli of stimulation. Uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal densitometry and central retinal thickness were also recorded. Results The preoperative mean values of P1 amplitudes for the 4 rings were R1=109.96±28.96 nV/deg2, R2=49.8±14.46, R3=29.85±8.9 and R4=19.33±6.3. At 2 weeks after CXL these values were R1=77.54±24.47, R2=36.55±12.53, R3=21.53±7.71 and R4=15.3±6.13, showing a statistically significant reduction for all rings (P.05). Corneal densitometry increased to statistically significant level at 2 (P
doi_str_mv 10.1111/j.1755-3768.2017.02383
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Methods Seventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 and 6 weeks postoperatively with mf‐ERG and OCT. The P1 amplitude of the photoreceptor response was documented in 4 concentric rings, with ring 1 (R1) representing the foveal response and rings 2–4 (R2‐R4) corresponding to the successive annuli of stimulation. Uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal densitometry and central retinal thickness were also recorded. Results The preoperative mean values of P1 amplitudes for the 4 rings were R1=109.96±28.96 nV/deg2, R2=49.8±14.46, R3=29.85±8.9 and R4=19.33±6.3. At 2 weeks after CXL these values were R1=77.54±24.47, R2=36.55±12.53, R3=21.53±7.71 and R4=15.3±6.13, showing a statistically significant reduction for all rings (P&lt;.05). At 6 weeks postoperatively P1 amplitudes were R1=99.8±31.23, R2=40.67±16.39, R3=24.98±7.13 and R4=16.35±4.84, showing for each ring no significant differences compared to preoperative values (P&gt;.05). Corneal densitometry increased to statistically significant level at 2 (P&lt;.001) and 6 weeks (P&lt;.001), demonstrating a weak negative correlation with the postoperative P1 amplitudes. UDVA and fovea thickness showed no significant changes at 2 and 6 weeks. Conclusions This is to our knowledge the first study assessing the photoreceptor response after CXL with the Dresden protocol. Although a temporary dysfunction of the photoreceptors the first postoperative weeks cannot be excluded, the increase of 6‐weeks‐P1 amplitudes at preoperative (physiologic) values confirms the safety standards of the duration and intensity of UVA radiation as proposed by the Dresden protocol.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/j.1755-3768.2017.02383</identifier><language>eng</language><publisher>Malden: Wiley Subscription Services, Inc</publisher><subject>Acuity ; Annuli ; Collagen ; Cornea ; Degeneration ; Densitometry ; Electroretinograms ; Evaluation ; Eye ; Fovea ; Keratoconus ; Optical Coherence Tomography ; Photoreception ; Photoreceptors ; Retina ; Statistical analysis ; Ultraviolet radiation ; Visual acuity</subject><ispartof>Acta ophthalmologica (Oxford, England), 2017-09, Vol.95 (S259), p.n/a</ispartof><rights>2017 The Authors Acta Ophthalmologica © 2017 Acta Ophthalmologica Scandinavica Foundation</rights><rights>Copyright © 2017 Acta Ophthalmologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1755-3768.2017.02383$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45551,46808</link.rule.ids></links><search><creatorcontrib>Lazaridis, A.</creatorcontrib><creatorcontrib>Tsamassiotis, S.</creatorcontrib><creatorcontrib>Besgen, V.</creatorcontrib><creatorcontrib>Sekundo, W.</creatorcontrib><creatorcontrib>Wenner, Y.</creatorcontrib><creatorcontrib>Droutsas, K.</creatorcontrib><title>Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)</title><title>Acta ophthalmologica (Oxford, England)</title><description>Purpose The evaluation of the effect of UVA radiation on the photoreceptors after CXL. Methods Seventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 and 6 weeks postoperatively with mf‐ERG and OCT. The P1 amplitude of the photoreceptor response was documented in 4 concentric rings, with ring 1 (R1) representing the foveal response and rings 2–4 (R2‐R4) corresponding to the successive annuli of stimulation. Uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal densitometry and central retinal thickness were also recorded. Results The preoperative mean values of P1 amplitudes for the 4 rings were R1=109.96±28.96 nV/deg2, R2=49.8±14.46, R3=29.85±8.9 and R4=19.33±6.3. At 2 weeks after CXL these values were R1=77.54±24.47, R2=36.55±12.53, R3=21.53±7.71 and R4=15.3±6.13, showing a statistically significant reduction for all rings (P&lt;.05). At 6 weeks postoperatively P1 amplitudes were R1=99.8±31.23, R2=40.67±16.39, R3=24.98±7.13 and R4=16.35±4.84, showing for each ring no significant differences compared to preoperative values (P&gt;.05). Corneal densitometry increased to statistically significant level at 2 (P&lt;.001) and 6 weeks (P&lt;.001), demonstrating a weak negative correlation with the postoperative P1 amplitudes. UDVA and fovea thickness showed no significant changes at 2 and 6 weeks. Conclusions This is to our knowledge the first study assessing the photoreceptor response after CXL with the Dresden protocol. Although a temporary dysfunction of the photoreceptors the first postoperative weeks cannot be excluded, the increase of 6‐weeks‐P1 amplitudes at preoperative (physiologic) values confirms the safety standards of the duration and intensity of UVA radiation as proposed by the Dresden protocol.</description><subject>Acuity</subject><subject>Annuli</subject><subject>Collagen</subject><subject>Cornea</subject><subject>Degeneration</subject><subject>Densitometry</subject><subject>Electroretinograms</subject><subject>Evaluation</subject><subject>Eye</subject><subject>Fovea</subject><subject>Keratoconus</subject><subject>Optical Coherence Tomography</subject><subject>Photoreception</subject><subject>Photoreceptors</subject><subject>Retina</subject><subject>Statistical analysis</subject><subject>Ultraviolet radiation</subject><subject>Visual acuity</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkctuGjEUhq2olZrSvkJlKRtYQMbjGTNU3SBELhISEiVVdpZnfAymHpt6DBG7PEJeLi_QJ6lniLKuN8fn8v3H8o_QN5KMSDzXuxEZ5_mQjlkxShMyHiUpLegFunwvf3i_54-f0Oem2SUJI4xll-h1BUfd6KDtBlfOWxAmRmPEBiyuvGsao63-3bb7s8fFADdCQTh9x_OjMAcRtLPYKRy2gEEpqEKbHUzw4qidgfD3-WWK-w-_pgPshdRvgO0AD3GtwE86bHEdGa1cFdeDiTLedV238aLG_VpFnfnqdoCFldjtg666d27Bg60AB1e3k_vtCfeXs_XgC_qohGng61vsoYeb-Xp2N1wsb-9n08WwImlBh5RQKYhMpSxzmVEmSgGTTEJJC6iUKjIiJcRqOUkTlo4zlUGSCyZkUZSlopL20NVZd-_dnwM0ge_cwdu4kpMJZWlWkBh7iJ2nuv_0oPje61r4EycJby3kO976w1uveGsh7yyM4I8z-KQNnP6T4tPlzzP-DxUip6U</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Lazaridis, A.</creator><creator>Tsamassiotis, S.</creator><creator>Besgen, V.</creator><creator>Sekundo, W.</creator><creator>Wenner, Y.</creator><creator>Droutsas, K.</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope></search><sort><creationdate>201709</creationdate><title>Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)</title><author>Lazaridis, A. ; Tsamassiotis, S. ; Besgen, V. ; Sekundo, W. ; Wenner, Y. ; Droutsas, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1283-313da1d2ddb5d436abae94deb38ecff841dde6abb9206274f4e05a6ad88bbf3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acuity</topic><topic>Annuli</topic><topic>Collagen</topic><topic>Cornea</topic><topic>Degeneration</topic><topic>Densitometry</topic><topic>Electroretinograms</topic><topic>Evaluation</topic><topic>Eye</topic><topic>Fovea</topic><topic>Keratoconus</topic><topic>Optical Coherence Tomography</topic><topic>Photoreception</topic><topic>Photoreceptors</topic><topic>Retina</topic><topic>Statistical analysis</topic><topic>Ultraviolet radiation</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lazaridis, A.</creatorcontrib><creatorcontrib>Tsamassiotis, S.</creatorcontrib><creatorcontrib>Besgen, V.</creatorcontrib><creatorcontrib>Sekundo, W.</creatorcontrib><creatorcontrib>Wenner, Y.</creatorcontrib><creatorcontrib>Droutsas, K.</creatorcontrib><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lazaridis, A.</au><au>Tsamassiotis, S.</au><au>Besgen, V.</au><au>Sekundo, W.</au><au>Wenner, Y.</au><au>Droutsas, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><date>2017-09</date><risdate>2017</risdate><volume>95</volume><issue>S259</issue><epage>n/a</epage><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>Purpose The evaluation of the effect of UVA radiation on the photoreceptors after CXL. Methods Seventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 and 6 weeks postoperatively with mf‐ERG and OCT. The P1 amplitude of the photoreceptor response was documented in 4 concentric rings, with ring 1 (R1) representing the foveal response and rings 2–4 (R2‐R4) corresponding to the successive annuli of stimulation. Uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal densitometry and central retinal thickness were also recorded. Results The preoperative mean values of P1 amplitudes for the 4 rings were R1=109.96±28.96 nV/deg2, R2=49.8±14.46, R3=29.85±8.9 and R4=19.33±6.3. At 2 weeks after CXL these values were R1=77.54±24.47, R2=36.55±12.53, R3=21.53±7.71 and R4=15.3±6.13, showing a statistically significant reduction for all rings (P&lt;.05). At 6 weeks postoperatively P1 amplitudes were R1=99.8±31.23, R2=40.67±16.39, R3=24.98±7.13 and R4=16.35±4.84, showing for each ring no significant differences compared to preoperative values (P&gt;.05). Corneal densitometry increased to statistically significant level at 2 (P&lt;.001) and 6 weeks (P&lt;.001), demonstrating a weak negative correlation with the postoperative P1 amplitudes. UDVA and fovea thickness showed no significant changes at 2 and 6 weeks. Conclusions This is to our knowledge the first study assessing the photoreceptor response after CXL with the Dresden protocol. Although a temporary dysfunction of the photoreceptors the first postoperative weeks cannot be excluded, the increase of 6‐weeks‐P1 amplitudes at preoperative (physiologic) values confirms the safety standards of the duration and intensity of UVA radiation as proposed by the Dresden protocol.</abstract><cop>Malden</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/j.1755-3768.2017.02383</doi><tpages>1</tpages></addata></record>
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subjects Acuity
Annuli
Collagen
Cornea
Degeneration
Densitometry
Electroretinograms
Evaluation
Eye
Fovea
Keratoconus
Optical Coherence Tomography
Photoreception
Photoreceptors
Retina
Statistical analysis
Ultraviolet radiation
Visual acuity
title Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)
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