Reliability of self-measurement of visual acuity in AMD patients with two electronic devices based on the ETDRS chart: A randomized study.

INTRODUCTION: Age-related macular degeneration (AMD) requires continuous visual acuity (VA) monitoring, increasing the burden on the health care system. Self-measurement VA tests are available on various devices. However, none of them have been based on an internationally validated benchmark chart, such as that of the Early Treatment Diabetic Retinopathy Study (ETDRS). The goal of this study was to assess the reliability of two digitized ETDRS charts adapted to two electronic devices for self-measurement of VA. MATERIAL AND METHODS: A prospective, single-center, 1:1 randomized, two-arm, parallel group trial was conducted. The main objective was to compare VA variation as conventionally measured on a 4-m ETDRS chart versus self-measured with digitized ETDRS charts in patients treated for AMD. At each visit, conventional measurement and patient self-measurement, either on a computer at 80-cm (arm 1) or on a tablet at 40-cm (arm 2), were performed. RESULTS: Eighty patients were included (25 men, 55 women, mean age 81.3±7.4 years). No significant differences were observed between VA variation, conventionally measured and self-measured on a computer (arm 1; P=0.914) or tablet (arm 2; P=0.913). CONCLUSION: These results confirm the reliability of these two methods for self-measurement of VA, and will lead to the development of a wider "telemedicine" project extended to self-measurement of VA in various pathologies.

[Anatomical and functional repercussions of internal limiting membrane peeling in epiretinal membrane surgery]. / Retentissements anatomique et fonctionnel du pelage de limitante interne dans la chirurgie de membrane épirétinienne.

We report the case of a 67-year-old woman who underwent epiretinal membrane surgery with internal limiting membrane peeling via a 23-gauge vitrectomy. Postoperative OCT and fundus photography revealed two forms of cicatrization: a dissociation of the retinal nerve fiber layer (DONFL) over the entire area of internal limiting membrane peeling, and an arcuate zone of retinal nerve fiber layer swelling (SANFL) at the site where the peeling had been initiated. Functionally, the patient demonstrated improved postoperative near acuity and a decrease in metamorphopsia. Mean retinal sensitivity measured by MP1 microperimetry at 3months was reduced by more than 30%. Microscotomata are more marked in the zone of inititation of peeling.