Okuvision GmbH, Reutlingen, Germany.
Centre for Ophthalmology, University Eye Hospital, Eberhard-Karls University Tübingen, Tübingen, Germany.
Transl Vis Sci Technol. 2023 Feb 1;12(2):29. doi: 10.1167/tvst.12.2.29.
To assess whether transcorneal electrical stimulation (TcES) current-dependently slows progressive loss of visual field area (VFA) in retinitis pigmentosa (RP).
Data from 51 patients with RP who received monocular TcES treatment once weekly over 1 year in an interventional, randomized study have been analyzed a posteriori. Current amplitudes were 0.1 to 1.0 mA in the TcES-treated group (n = 31) and 0.0 mA in the sham group (n = 20). VFA was assessed in both eyes (semiautomatic kinetic perimetry, Goldmann targets V4e, III4e). Annual decline rate (ADR) of exponential loss and model-independent percentage reduction of VFA at treatment cessation were correlated to current amplitude.
For V4e, mean ADR was -4.1% in TcES-treated eyes, -6.4% in untreated fellow eyes, and -7.2% in placebo-treated eyes; mean VFA reduction in TcES-treated eyes was 64% less than in untreated fellow eyes (P = 0.013) and 72% less than in placebo-treated eyes (P = 0.103). Individual VFA reductions correlated with current amplitude (P = 0.043) and tended toward zero in patients who received 0.8 to 1.0 mA. For III4e, there was a marginally significant current-dependency of interocular difference in reduction (P = 0.11). ADR and VFA reduction did not significantly correlate with baseline VFA.
Loss of VFA (V4e) in patients with RP was significantly reduced in treated eyes compared to untreated eyes by regular use of TcES in a dose-dependent manner. No dependence of effects on the initial extent of VFA loss was found.
TcES provides potential for preservation of visual field in patients with RP.
评估经角膜电刺激（TcES）电流是否会减缓色素性视网膜炎（RP）患者视野面积（VFA）的进行性丧失。
对接受单眼 TcES 治疗的 51 例 RP 患者的数据进行了回顾性分析，这些患者在一项干预性、随机研究中每周接受一次治疗，持续 1 年。TcES 治疗组（n=31）的电流幅度为 0.1 至 1.0 mA，假刺激组（n=20）的电流幅度为 0.0 mA。使用半自动化动态视野计（Goldmann 靶 V4e、III4e）评估双眼 VFA。治疗结束时指数损失的年下降率（ADR）和 VFA 的模型独立百分比减少与电流幅度相关。
对于 V4e，TcES 治疗眼的平均 ADR 为-4.1%，未治疗对侧眼为-6.4%，假刺激眼为-7.2%；TcES 治疗眼的 VFA 平均减少量比未治疗对侧眼少 64%（P=0.013），比假刺激眼少 72%（P=0.103）。个体 VFA 减少与电流幅度相关（P=0.043），在接受 0.8 至 1.0 mA 电流刺激的患者中，该相关性趋于零。对于 III4e，减少的眼间差异与电流呈边缘显著相关性（P=0.11）。ADR 和 VFA 减少与基线 VFA 无显著相关性。
与未治疗的眼睛相比，常规使用 TcES 以剂量依赖的方式治疗 RP 患者，可显著减少治疗眼中的 VFA（V4e）损失。未发现疗效与初始 VFA 丧失程度之间存在依赖性。
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