Abstract

Research Article

Evaluation of the efficacy of transcorneal electric stimulation therapy in retinitis pigmentosa patients with electrophysiological and structural tests

Mualla Sahin Hamurcu*, Sema Akkan Aydogmuş and M. Sinan SARICAOĞLU

Published: 20 May, 2020 | Volume 4 - Issue 1 | Pages: 031-037

A Statement of significance: This study shows that the effect of transcorneal electrical stimulation (TES) therapy as a stimulator device in retinitis pigmentosa (RP)patients with have a significant increase in visual acuity and shortening of p100 latency in pattern visual evoked potential (pVEP) test during 3 months follow up.

Purpose: To assess the safety and efficacy of TES therapy with electrophysiological and structural tests in RP patients.

Methods: Thirty four eyes of 17 RP patients were included in the study. Initial examination included best corrected visual acuity (BCVA) and visual field (VF) test (Humphrey). Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) were measured with using swept-source optical coherence tomography (OCT). The patients were tested by Metrovision brand monpack model visual eletrophysiology device for pVEP and flash electroretinogram (fERG) tests. Patients were seen 12 times during 3 months: initial visit for screening and weekly visits for TES. All tests were repeated 3 times. The results of pre and post TES therapy were compared.

Results: Patients’ baseline BCVA was 0,34 ± 0,22. The increase in the last visit BCVA was significant (p : .001) and it was 0.50 ± 0.29. The difference between CMT, RNLF and CT pre and post TES therapy were not significant (p > .05). The mean latencies of the 120’ pattern p100 waves that patients could see were shortened and statistically significant (p = .04). The peaks amplitudes of the 120’ pattern p100 waves that patients could see were increased; but not statistically significant (p :. 19).

Conclusion: This study shows that the safety of TES as a stimulator device in our patient group and the effect on this group have a significant increase in visual acuity and shortening of p100 latency in pVEP test during 3 months follow up.

Read Full Article HTML DOI: 10.29328/journal.ijceo.1001030 Cite this Article Read Full Article PDF

Keywords:

Flash electroretinogram; Retinitis pigmentosa; Transcorneal electrical stimulation; Visual acuity; Visual evoked potential

References

  1. Heckenlively JR. Retinitis Pigmentosa. Philadelphia: JB Lippincott. 1988.:
  2. Hartong DT, Berson EL, Dryja TP. Retinitis Pigmentosa. Lancet. 2006; 368: 1795–809. PubMed: https://pubmed.ncbi.nlm.nih.gov/17113430/
  3. He Y, Zhang Y, Su G. Recent Advances in Treatment of Retinitis Pigmentosa. Curr Stem Cell Res Ther. 2015; 10: 258-265. PubMed: https://pubmed.ncbi.nlm.nih.gov/25345673/
  4. Grunwald JE, Maguire AM, Dupont J. Retinal Hemodynamics in Retinitis Pigmentosa. Am J Ophthalmol. 1996; 122: 502-508. PubMed: https://pubmed.ncbi.nlm.nih.gov/8862046/
  5. Gekeler F, Bartz-Schmidt KU. Electrical stimulation-a therapeutic strategy for retinal and optic nerve disease? Graefes Arch Clin Exp Ophthalmol. 2012; 2: 161-163. PubMed: https://pubmed.ncbi.nlm.nih.gov/22282217/
  6. Fujikado T, Morimoto T, Matsushita K, Shimojo H, Okawa Y, et al. Effect of Transcorneal Electrical Stimulation in Patients with Nonarteritic Ischemic Optic Neuropathy or Traumatic Optic Neuropathy. Jpn J Ophthalmol. 2006; 50: 266–273. PubMed: https://pubmed.ncbi.nlm.nih.gov/16767383/
  7. Fedorov A, Chibisova Y, Szymaszek A, Alexandrov M, Gall C, et al. Non-invasive Alternating Current Stimulation Induces Recovery From Stroke. Restor Neurol Neurosci. 2010; 28: 825–833. PubMed: https://pubmed.ncbi.nlm.nih.gov/21209497/
  8. Tao Y, Chen T, Liu B, Peng GH, Qin LM, et al. The Transcorneal Electrical Stimulation as a Novel Therapeutic Strategy Against Retinal and Optic Neuropathy: a Review of Experimental and Clinical Trials. Int J Ophthalmol. 2016; 9: 914-919. PubMed: https://pubmed.ncbi.nlm.nih.gov/27366697/
  9. De Santana JM, Walsh DM, Vance C, Rakel BA, Sluka KA, et al. Effectiveness of Transcutaneous Electrical Nerve Stimulation for Treatment of Hyperalgesia and Pain. Curr Rheumatol Rep. 2008; 10: 492–499. PubMed: https://pubmed.ncbi.nlm.nih.gov/19007541/
  10. Kleinjung T, Steffens T, Londero A, Langguth B. Transcranial Magnetic Stimulation (TMS) for Treatment of Chronic Tinnitus: Clinical Effects. Prog Brain Res. 2007; 166: 359–367. PubMed: https://pubmed.ncbi.nlm.nih.gov/17956800/
  11. Odom JV, Bach M, Brigell M, Holder GE, McCulloch DL, et al. ISCEV Standard for Clinical Visual Evoked Potentials. Doc Ophthalmol. 2016; 133: 1-9. PubMed: https://pubmed.ncbi.nlm.nih.gov/27443562/
  12. Dawson WW, Trick GL, Litzkow CA. Improved Electrode for Electroretinography. Invest Ophthalmol Vis Sci. 1979; 18: 988. PubMed: https://pubmed.ncbi.nlm.nih.gov/478786/
  13. Ma Z, Cao P, Sun P, Li L, Lu Y, et al. Optical Imaging of Visual Cortical Responses Evoked by Transcorneal Electrical Stimulation with Different Parameters. Invest Ophthalmol Vis Sci. 2014; 55: 5320-5331. PubMed: https://pubmed.ncbi.nlm.nih.gov/25082881/
  14. Inomata K, Shinoda K, Ohde H, Tsunoda K, Hanazono G, et al. Transcorneal Electrical Stimulation of Retina to Treat Longstanding Retinal Artery Occlusion. Graefes Arch Clin Exp Ophthalmol. 2007; 245: 1773–1780. PubMed: https://pubmed.ncbi.nlm.nih.gov/17593383/
  15. Gekeler F, Messias A, Ottinger M, Bartz-Schmidt KU, Zrenner E. Phosphenes Electrically Evoked with DTL Electrodes: a Study in Patients with Retinitis Pigmentosa, Glaucoma, and Homonymous Visual Field Loss and Normal Subjects. Invest Ophthalmol Vis Sci. 2006; 47: 4966–4974. PubMed: https://pubmed.ncbi.nlm.nih.gov/17065515/
  16. Morimoto T, Fujikado T, Choi JS, Kanda H, Miyoshi T, et al. Transcorneal Electrical Stimulation Promotes the Survival of Photoreceptors and Preserves Retinal Function in Royal College of Surgeons Rats. Invest Ophthalmol Vis Sci. 2007; 48: 4725-4732. PubMed: https://pubmed.ncbi.nlm.nih.gov/17898297/
  17. Sato T, Fujikado T, Lee TS, Matsushita K, Harada T, et al. Direct Effect of Electrical Stimulation on Induction of Brain-derived Neurotrophic Factor from Cultured Retinal Muller cells. Invest Ophthalmol Vis Sci. 2008; 49: 4641-4646. PubMed: https://pubmed.ncbi.nlm.nih.gov/18661273/
  18. Sato T, Fujikado T, Lee TS, Matsushita K, Harada T, et al. Effect of Electrical Stimulation on IGF-1 Transcription by L-type Calcium Channels in Cultured Retinal Muller cells. Jpn J Ophthalmol. 2008; 52: 217-223. PubMed: https://pubmed.ncbi.nlm.nih.gov/18661273/
  19. Kurimoto T, Oono S, Oku H, Tagami Y, Kashimoto R, et al. Transcorneal electrical stimulation increases chorioretinal blood flow in normal human subjects. Clin Ophthalmol. 2010; 4: 1441–1446. PubMed: https://pubmed.ncbi.nlm.nih.gov/21188156/
  20. Robles-Camarillo D, Nino-de-RiveraL, Lopez-Miranda J, et al. The Effect of Transcorneal Electrical Stimulation in Visual Acuity: Retinitis pigmentosa. J Biomedical Sci Engineering. 2013; 6: 1-7.
  21. Schatz A, Röck T, Naycheva L, Willmann G, Wilhelm B, et al. Transcorneal Electrical Stimulation for Patients with Retinitis Pigmentosa: a Prospective, Randomized, Sham-controlled Exploratory Study. Invest Ophthalmol Vis Sci. 2011; 52: 4485–4496. PubMed: https://pubmed.ncbi.nlm.nih.gov/21467183/
  22. Schatz A, Pach J, Gosheva M, Willmann G, Wilhelm B, et al. Transcorneal Electrical Stimulation for Patients with Retinitis Pigmentosa: A Prospective, Randomized, Sham-Controlled Follow-up Study over 1 Year. Invest Ophthalmol Vis Sci. 2017; 58: 257-269. PubMed: https://pubmed.ncbi.nlm.nih.gov/21467183/
  23. Wagner SK, Jolly JK, Pefkianaki M, Gekeler F, Webster AR, et al. Transcorneal Electrical Stimulation for the Treatment of Retinitis Pigmentosa: Results from the TESOLAUK trial. BMJ Open Ophthalmol. 2017; 2 :e000096 PubMed: https://pubmed.ncbi.nlm.nih.gov/29354722/
  24. Bittner AK, Seger K. Longevity of Visual Improvements Following Transcorneal Electrical Stimulation and Efficacy of Retreatment in Three Individuals with Retinitis Pigmentosa. Graefes Arch Clin Exp Ophthalmol. 2018; 256: 299–306. PubMed: https://pubmed.ncbi.nlm.nih.gov/29222719/
  25. Bittner AK, Seger K, Salveson R, Kayser S, Morrison N, et al. Randomized Controlled Trial of Electro-Stimulation Therapies to Modulate Retinal Blood Flow and Visual Function in Retinitis Pigmentosa. Acta Ophthalmol. 2018; 96: e366-e376. PubMed: https://pubmed.ncbi.nlm.nih.gov/29130647/
  26. Mumcuoglu T, Erdurman C, Durukan AK. Principles of optical coherence tomography and application innovations. T Oft Gaz. 2008; 38: 168-175.

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?