الفهرس 
Retinal pigment epithelium (RPEOnly 14 pages are availabe for public view
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Abstract
Age related macular degeneration is a major cause of vision loss in developed countries. neovascular age related macular degeneration accounts for about 80% of cases with severe visual loss. mfERG is one of functional tests used to assess retinal function in nvAMD cases. It allows detailed topographic mapping of retinal function. Ranibizumab (Lucentis) is the first FDA approved anti-VEGF drug for all types of nvAMD. This study was a prospective, observational study carried on 30 eyes of 27 treatment naïve patients diagnosed with nvAMD. The study aimed at correlation of macular structure assessed by SD-OCT with macular function assessed by mfERG and BCVA in nvAMD cases. BCVA and SD-OCT and mfERG were done on each eye at the time of diagnosis . Then ,patients received 3 loading doses of 0.5mg Ranibizumab 4weeks interval each as a part of their treatment regimen by Tanta university. One month later SD-OCT, BCVA and mfERG repeated. The relation between BCVA , Ellipsoid zone assessed by OCT and mfERG was established. Our study didn’t only proved the known effect on Ranibizumab in improving VA, restoration of EZ and reduction of size and thickness of CNV. But also showed a statistically significant improvement in all mfERG parameters used in this study that included P1 amplitude, Avg P1+P2 amplitude, P1 latency, P1 response density and N1 amplitude. This showed the undeniably accurate role of mfERG as a functional test that can be used in nvAMD cases to highlight functional changes that can’t be elicited by routine visual acuity measurement. Positive correlation was detected between improvement in BCVA and EZ restoration but it wasn’t statistically significant mostly due to the small sample size. A statically significant negative correlation between BCVA and CNV size. BCVA wasn’t correlated with CNV thickness. Positive correlation in current study between BCVA and P1 response density was confirmed. BCVA was also strongly correlated with Avg P1+P2 amplitude in R1+R2. No correlation between BCVA and P1 amplitude was detected in our study. We attribute this finding to the lack of fixation in nvAMD cases. A statistically significant correlation between EZ and CNV size was detected, while EZ wasn’t correlated with CNV thickness. A statistically significant positive correlation between EZ and N1 amplitude in R1 detected in current study. We also detected a strong positive correlation between EZ and Avg P1+P2 amplitude. No correlation was detected between P1 amplitude or P1 latency with EZ in this study. CNV size was correlated with N1 amplitude and P1 implicit time. CNV thickness wasn’t correlated with any of mfERG parameters. EZ restoration showed a statistically significant reduction in cases with residual CNV activity. While, BCVA reduction wasn’t statistically significant . These findings highlighted one of current study drawbacks which is limitation of number of injections to 3 only. There are other limitations of the study which include the small sample size, defective fixation that limits optimal use of mfERG and no follow up was done at larger period intervals.