Kristina Holm

Lund University, Lund, Skane, Sweden

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Publications (7)12.52 Total impact

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    ABSTRACT: To study the relationship between macular function assessed by multifocal electroretinogram (mfERG) and morphological changes evaluated with optical coherence tomography (OCT) and fundus photography in patients with drusen maculopathy. Ten patients (age 71 ± 5 years) with drusen maculopathy were compared to fifteen healthy control patients (age 67 ± 7 years). One eye per patient was examined with OCT, color fundus pictures, and mfERG (103 hexagons) recorded in nine areas corresponding to the nine areas of the OCT retinal map. Drusen density for every separated area was registered. All nine areas in the maculopathy group demonstrated prolonged implicit time compared to healthy controls; the mean value for the maculopathy group was 31.3 milliseconds (95% confidence intervals [CI]: 30.9-31.6) vs 27.9 milliseconds (95% CI: 27.5-28.2; P = 0.006) for the control group. The amplitude in the foveal area was lower in the maculopathy group; the mean value for the maculopathy group was 25.1 nV/deg(2) (95% CI: 18.4-31.7) vs 33.9 nV/deg(2) (95% CI: 27-40.9; P = 0.03) for the control group. mfERG in the maculopathy group demonstrated no differences in areas with or without drusen. There was no correlation between the retinal thickness assessed with OCT and the mfERG response. Eyes with drusen maculopathy demonstrated functional changes compared to healthy controls evaluated with mfERG. Drusen seems to be associated with general macular dysfunction.
    Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:1303-9.
  • Kristina Holm, Monica Lövestam Adrian
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    ABSTRACT: The purpose of the present study was to compare retinal function between the perifoveal nasal and perifoveal temporal areas of diabetic eyes using multifocalERG (mfERG). We included 36 eyes from 27 patients with diabetes (age 58 ± 14 years; duration of diabetes 13 ± 9 years; HbA(1c) 7.1 ± 1.8%) and a control group with 18 eyes from 18 healthy subjects (age 57 ± 11 years). Retinal thickness was assessed with optical coherence tomography (OCT) in the perifoveal areas corresponding to the summed nasal and temporal inner and outer areas. MfERG amplitude and implicit time were recorded from corresponding areas. Diabetic eyes showed lower mfERG amplitude in the nasal area than in the temporal area (14 ± 6 vs 17 ± 7 nV/deg(2); p < 0.0001) and longer implicit time (31 ± 3 vs 30 ± 3 ms; p = 0.005). In the control group, there were no significant differences between the two areas. Diabetic eyes showed lower amplitude and longer implicit time in the nasal area than in the temporal, which might indicate that the nasal area is more vulnerable. These findings may be of importance for evaluation of diabetic maculopathy and outcome after laser treatment.
    Albrecht von Graæes Archiv für Ophthalmologie 02/2012; 250(8):1143-8. · 1.93 Impact Factor
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    ABSTRACT: To evaluate the influence of hard exudates on macular function in patients with diabetic retinopathy. Thirty seven eyes from 27 diabetic patients, aged 57 +/- 14 years, diabetes duration 12.5 +/- 9 years, not previously treated with photocoagulation, underwent fundus photography, multifocal electroretinography (mfERG) and optical coherence tomography (OCT). Hard exudates were graded from fundus photography with superimposed OCT and a superimposed hexagonal pattern (mfERG) by one retinal specialist, unaware of mfERG and OCT results. We defined three groups; A = eyes with exudates in the analyzed zone, B = eyes with no exudates in the analyzed zone but elsewhere, and C = eyes with no exudates. The mfERG responses and OCT values from five defined areas in the macula were compared. MfERG showed that the implicit time was significantly prolonged in group A compared to group C in the central, middle and outer areas and in the nasal and temporal area (p = 0.045, 0.019, 0.017 and 0.035 and 0.016 respectively), in group B compared to group C in the central area (p = 0.016), and in group A compared to group B in the outer area (p = 0.035). Amplitude differed between group A and C in the middle area and outer area (14.2 +/- 5.2 nV/deg(2) vs 21.1 +/- 8.7 nV/deg(2), p = 0.037 and 14.1 +/- 3.9 nV/deg(2) vs 17.7 +/- 7.1 nV/deg(2) , p = 0.02 respectively), and between group B and C in the temporal area 14.5 +/- 2.2 nV/deg(2) vs 20.0 +/- 8.7 nV/deg(2), p = 0.017). Macular thickness assessed with OCT was similar between the groups. In eyes with diabetic retinopathy, hard exudates prolong the implicit time assessed with mfERG, compared to eyes without hard exudates, and independently of macular thickness. These results indicate that the hard exudates in the macular region, even at a distance from the fovea centre, have a deleterious effect on macular function.
    Albrecht von Graæes Archiv für Ophthalmologie 03/2010; 248(9):1241-7. · 1.93 Impact Factor
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    Monica Lövestam-Adrian, Kristina Holm
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    ABSTRACT: This study aimed to evaluate local response on multifocal electroretinography (mfERG) and to assess retinal thickness with optical coherence tomography (OCT) after focal laser treatment in areas with retinal oedema and exudates in patients with diabetic retinopathy. Twelve diabetes patients (aged 60 +/- 14 years, diabetes duration 16 +/- 8 years) treated with focal or grid photocoagulation in areas with retinal oedema and/or exudates underwent mfERG and OCT before and 3 months after treatment. The average thickness (in microm) in any of the nine sectors (defined according to the ETDRS) treated with photocoagulation was measured. Amplitudes and implicit times were analysed in corresponding areas on the mfERG. Mean mfERG amplitudes increased after photocoagulation (21.5 +/- 8.0 nV/deg(2) versus 16.8 +/- 6.1 nV/deg(2); p = 0.012), whereas no difference was seen in implicit times. Mean OCT values in the treated regions were lower at follow-up (272 +/- 23 microm versus 327 +/- 79 microm; p = 0.013). No correlation was seen between changes in mfERG response and changes in OCT values. The decrease in retinal thickness was correlated with the number of laser spots applied (p = 0.002). Focal argon laser treatment is effective in reducing retinal thickness. In addition, treated areas tend to show improved retinal function as demonstrated by increased amplitudes on mfERG.
    Acta ophthalmologica 03/2009; 88(2):188-92. · 2.44 Impact Factor
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    ABSTRACT: To study the relationship between foveal thickness assessed by optical coherence tomography (OCT) and foveal function measured with multi focal electroretinography (mfERG) in patients with non-proliferative diabetic retinopathy, and with no previous laser treatment. Twenty-six eyes from 18 diabetic patients (13 men), aged 59 years, (range 28-79 years), diabetes duration 15 years, (range 2-27 years), with a macular thickness between 200 and 600 microm were evaluated by mfERG, visual acuity (ETDRS score) and OCT. Mean amplitudes and implicit times of the mfERG responses were analyzed within the four innermost (14 degrees) of the six concentric rings. For comparison with the results from the OCT (diameter of measured area = 6 mm) we analyzed the summed response from the first and second ring (central zone), corresponding to the central area of the OCT. The third(zone 2) and fourth (zone 3)of the four innermost of the six concentric rings measured by the mfERG corresponding to the second and third area of OCT. An increased macular thickness in the central area of the OCT correlated to reduced amplitudes (r = -0.541; P = 0.004) and prolonged implicit times (r = 0.548; P = 0.004) in the central zone of the mfERG, and inversely correlated with visual acuity, -0.49; P = 0.045. Retinal thickness in the second area was correlated to prolonged implicit times in the second mfERG zone (r = -0.416; P = 0.034). No correlations were found for the third area of the OCT. When macular thickness exceeded 300 mum the decrease of amplitudes and prolonged implicit times, measured by mfERG, seemed to be more pronounced. In conclusion increased macular thickness is correlated with reduced amplitudes and prolonged implicit times on the mf ERG and worse visual acuity.
    Documenta Ophthalmologica 06/2007; 114(3):117-24. · 1.54 Impact Factor
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    ABSTRACT: To investigate central and peripheral retinal function after scleral buckling surgery for recent onset rhegmatogenous retinal detachment (RD). Fifteen phakic patients with rhegmatogenous RD for <1 week underwent scleral buckling surgery. Clinical investigation, optical coherence tomography (OCT), full-field electroretinography (ERG), and multifocal ERG (mfERG) with fundus illumination were performed preoperatively and 6 months postoperatively. Anatomical success was achieved in 14 patients. mfERG amplitudes were reduced preoperatively in detached retina, with significant improvement at follow-up (P = 0.002). Foveal amplitudes improved significantly (P = 0.027). There was no significant difference in postoperative mfERG amplitudes between areas that had been preoperatively detached or attached (P = 0.739). In the subgroup of eight patients in whom the detachment engaged the fovea preoperatively, rod function improved significantly as assessed with full-field ERG (P = 0.008). In these patients, the extent of detachment ranged between 4 clock hours and 6 clock hours, as compared with 2 clock hours and 5 clock hours in the remaining patients. OCT showed subretinal foveal fluid in four patients at follow-up. In recent onset rhegmatogenous RD, total rod and localized central retinal dysfunction in detached retina can improve significantly after reattachment. mfERG and OCT are suitable tools for further studies of functional outcomes in RD.
    Retina 02/2007; 27(1):30-6. · 2.83 Impact Factor
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    ABSTRACT: To evaluate the prognostic influence of the presence of an operculum in macular hole and to correlate the prognosis for postoperative visual acuity (VA) with the size of the macular hole, its duration and preoperative VA. We carried out a prospective study of 61 eyes of 59 patients with full thickness macular hole. All patients were examined with optical coherence tomography (OCT) in order to ascertain the presence of an operculum. The VA was measured with the ETDRS chart. A standard pars plana vitrectomy with inner limiting membrane peeling was performed in all cases and 20% C2F6 was used as tamponade. Anatomical closure was obtained after one surgical procedure in 59/61 (97%) patients. Linear regression analysis showed only baseline VA to be predictive of visual outcome (p < 0.001). The presence of an operculum preoperatively did not correlate with VA either pre- or postoperatively, nor with the anatomical closure rate. The finding that postoperative VA in macular hole correlates with preoperative VA seems to allow for good prediction of postoperative VA in macular hole surgery. However, the presence of an operculum is of no prognostic significance.
    Acta Ophthalmologica Scandinavica 07/2006; 84(3):301-4. · 1.85 Impact Factor