Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients

This report evaluates the prognostic value of parametric electroretinography (ERG) techniques in the development of rubeosis in central retinal vein occlusion (CRVO). An ERG protocol was followed on the initial clinic visit for 21 CRVO patients. None of these patients had neovascular complications or any treatment before the ERG examination. The ERG data were used to define an intensity-response (I-R) function, b-wave to a-wave peak ratio (b/a-wave ratio), and 30-Hz b-wave implicit time. A Naka-Rushton function was fitted to the I-R data to obtain values for maximum saturated response (Rmax) and for the log of the half-saturation intensity (log K). The authors' results show that ERG parameters relating both to the effective number of responding retinal elements and to the sensitivity of responding elements have significant prognostic value. Unexpectedly high predictive values were found for the Rmax and b/a ratio, parameters thought to correlate with the effective number of responding elements, compared with log K and 30-Hz implicit time, parameters thought to relate more closely to retinal ischemia. A multiple discriminant analysis, combining information from these ERG parameters, allowed separation of CRVO patients in whom rubeosis would develop from those in whom it would not, with a false-positive rate of only 14%.