ABSTRACT
BACKGROUND: The study compares the change in best-corrected visual acuity with the change in central retinal sensitivity before treatment and 6 months after treatment with photodynamic therapy in patients with symptomatic central serous chorio retinopathy. DESIGN: Prospective, single-centre, interventional case series. PARTICIPANTS: Eleven consecutive patients with previously untreated central serous chorio retinopathy. METHODS: Patients had microperimetry and best-corrected visual acuity recorded before and 6 months after treatment with photodynamic therapy. Refracted best-corrected visual acuity was assessed at 2 m and adjusted to give the number of letters read at 1 m. Threshold microperimetry was performed by presenting a Goldman III stimulus to 29 points over the central 12° around fixation. Significant visual improvement at 6 months was defined as a best-corrected visual acuity ≥10 letters or, microperimetry change in mean retinal sensitivity ≥2 decibels (dB). MAIN OUTCOME MEASURES: Improvement in best-corrected visual acuity compared with microperimetry following photodynamic therapy treatment in patients with central serous chorio retinopathy. RESULTS: All patients reported a subjective improvement in vision and had complete resolution of subretinal fluid at 6 months. Two patients had a significant improvement in best-corrected visual acuity (mean ± SD +4.2 ± 5.8 letters), compared with all 11 patients who recorded a significant improvement in mean retinal sensitivity (mean ± SD 4.6 ± 1.9 dB) (P < 0.001). CONCLUSIONS: These data suggest that compared with microperimetry, best-corrected visual acuity is underestimating the effectiveness of photodynamic therapy in the treatment of central serous chorio retinopathy.
Subject(s)
Central Serous Chorioretinopathy/drug therapy , Photochemotherapy , Visual Acuity/physiology , Visual Field Tests , Visual Fields/physiology , Adult , Aged , Central Serous Chorioretinopathy/physiopathology , Female , Humans , Male , Middle Aged , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Prospective Studies , Retina/physiology , VerteporfinABSTRACT
PURPOSE: The purpose of this study was to compare the observed change in best-corrected visual acuity (BCVA) with the change in central retinal sensitivity pretreatment and 1 month after 3 consecutive treatments with ranibizumab in patients with wet age-related macular degeneration. METHODS: Ten consecutive patients with untreated age-related macular degeneration underwent microperimetric and BCVA assessment before and 1 month after 3 consecutive treatments with ranibizumab. Best-corrected visual acuity was assessed at 2 m by using the Early Treatment Diabetic Retinopathy Study chart. Threshold microperimetry was performed using a Goldman III stimulus to 45 points over the central 12 degrees of the macula. Significant visual improvement after treatment was defined as a change in BCVA >/=10 letters or, on microperimetry, a change in mean retinal sensitivity > or = 2 dB. RESULTS: One month after treatment, the median change in BCVA was +6 letters (range, -15 to +12), and the mean change in the mean retinal sensitivity was +2.86 dB (standard deviation, 1.55 dB). One patient recorded a significant improvement in BCVA compared with 8 patients who recorded a significant improvement in mean retinal sensitivity (P = 0.016). CONCLUSION: Compared with microperimetry, BCVA seems to significantly underestimate the change in visual function experienced by patients treated with ranibizumab.
