Clinical Application of Neuroprotection induced by Electrical Stimulation

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(1)Neuroprotection of photoreceptors by trancorneal electrical stimulation in RCS ratsIn the previous study, we confirmed nth effectiveness of Tanscorneal electrical stimulation (Tc ES) was effective to increase the survival rate of retinal ganglion cells (RGCs) in axotomized rat. In this study we examined the Effect of TcES on the survival rate of photoreceptors in royal college of surgeon's rat (RCS rat). TcES was applied once a week for 4 times from 3 week after birth. Electrortinography (ERG) showed significant large amplitude of scotopic threshold response (STR) in the treated group compared with the control group. Histological study showed the thickness of outer nuclear layer was significantly larger in the treated group compared with the control group. These data showed the effectiveness of TcES for the protection of photoreceptors.(2)Clinical study of TcES in patients of optic neuropathy.Based on the animal study, we investigated the effectiveness of TcES in patients with optic neuropathy. IRB was obtained from the committee of Osaka University Medical School. Thirteen eyes with anterior ischemic optic neuropathy, 7 eyes with traumatic optic neuropathy (TON) and 8 eyes with optic atrophy (OA) were enrolled in the study. After TcES, 4 eyes (31%) with AION, 2 eyes (29%) with TON and 2 eyes (25%) of OA showed an improvement of visual acuity equal or greater than 0.3 log MAR unit. We also investigated the threshold current to evoke pupillary reflex (TCPR), the threshold current to evoke central phosphene (TCCP) or peripheral phosphene (TCPP), visual acuity (VA), the area of visual field of Goldmann perimetry V/4 (AVF). The TCCP correlated with TCPR and VA. TCPP correlated with AVF. The improvement of VA after TcES correlated with the improvement of TCCP. These data suggested that the function of the central retina was reflected by TCCP and that of peripheral retina was reflected by TCPP. TCPR is an objective parameter to represent the total retinal function.