Association between hyperacuity defects and retinal microstructure in polypoidal choroidal vasculopathy.

Purpose: To improve our understanding of hyperacuity defects measured with preferential hyperacuity perimetry (PHP) by correlating PHP findings with the retinal microstructural changes visible on spectral‑domain optical coherence tomography (OCT) in patients with polypoidal choroidal vasculopathy (PCV). Materials and Methods: Twenty‑eight eyes of 28 patients with PCV were retrospectively reviewed. All patients underwent a complete ophthalmologic examination, including best‑corrected visual acuity (logMAR) testing, PHP, and OCT. The functional ‘PHP test score’ and ‘total volume of hyperacuity defect zone’ were also analyzed. Results: Patients were classified based on the hyperacuity defect by PHP, as follows: Hyperacuity defect (n = 17 eyes) group and hyperacuity intact (n = 11 eyes) group. The mean best‑corrected visual acuity in the hyperacuity intact group (0.46 ± 0.39) was better than that in the hyperacuity defect group (0.82 ± 0.37) (P = 0.014). The presence of serous retinal detachment and retinal pigment epithelial detachment did not differ significantly between groups (P = 0.120 and P = 0.689, respectively). A disrupted photoreceptor layer was more common in the hyperacuity defect group compared with the hyperacuity intact group (P = 0.0001). Among 17 eyes with a hyperacuity defect, 9 eyes showing intra‑retinal pathology (intra‑retinal cyst or hard exudates) and had a significantly higher PHP test score and larger total volume of the hyperacuity defect zone than 8 eyes without intra‑retinal pathology (P = 0.006 and P = 0.021, respectively). Conclusion: A hyperacuity defect in PCV was associated with photoreceptor disarrangement. Furthermore, PCV lesions on the inner retina that invaded the photoreceptor layer were associated with a more severe hyperacuity defect.

Preferential Hyperacuity Perimeter in Exudative AMD With Pigment Epithelial Detachment

PURPOSE: To analyze the hyperacuity defects by preferential hyperacuity perimeter (PHP) in exudative age-related macular degeneration (AMD) and correlate them with the properties of pigment epithelial detachment (PED) obtained by optical coherence tomography (OCT). METHODS: Thirty eyes with exudative AMD with choroidal neovascularization (CNV) diagnosed by fluorescein angiography underwent PHP for hyperacuity defect and OCT for PED length and height. We compared hyperacuity defect with the shape of the PED by OCT. RESULTS: 26 eyes with exudative AMD with CNV tested positive for hyperacuity defects. The size of the hyperacuity defect by PHP and the PED length by OCT showed positive correlation (p=0.010). In the 4 eyes that tested negative for hyperacuity defects, the PED was not high although the size was large. CONCLUSIONS: Our results suggest that PHP is a useful method to detect a change of pigment epithelial layer in AMD and the presences of a hyperacuity defect is more sensitive for PED height than size. These results suggest that PHP is useful to detect the state and the activity of CNV lesion.

Preferential Hyperacuity Perimeter (PHP) in Myopic CNV

PURPOSE: To analyze the hyperacuity defects of preferential hyperacuity perimeter (PHP) in myopic CNV and correlate with the other macular anatomical or physiological properties obtained with fluorescein angiography (FA), Optical coherence Tomography (OCT), and central perimeter. METHODS: Seven patients with myopic CNV diagnosed by FA underwent PHP, OCT, central visual field (VF). We examined the locational correlation among FA, central VF and PHP hyperacuity defect and then compared PHP hyperacuity defect with the CNV size by OCT. Also we made a comparison with macular sensitivity change in VF and hyperacuity defects change in PHP after PDT in 4 patients. RESULTS: All the 7 eyes with myopic CNV tested positive for hyperacuity defects. 5 eyes showed locational correlation among PHP and FA, central VF. The size of hyperacuity defect of PHP and CNV size by OCT was positive correlation (p=0.007). Four eyes treated with PDT showed decrease of PHP hyperacuity defect size and changes in location according to decrease of CNV size after PDT. CONCLUSIONS: Our results suggest that the PHP may be used to detect myopic CNV and beneficial for analyzing functional effect following PDT in myopic CNV patients. These results require further validation in a larger population.