Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study.

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) µm and improved to 252.5 (153-1405) µm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

Central field perimetry of discriminated targets: I. Results for normal individuals using high-contrast targets.

PURPOSE: A new perimetry method is described to evaluate central vision under multiple hue, illumination, and contrast conditions; results are described for normal individuals using high-contrast targets. METHODS: For 70 normal eyes of individuals with varying age, the ETDRS chart acuity was determined as well as discriminated target perimetry using high-contrast targets presented for 250 ms at locations up to 10 degrees eccentricity. Retesting was performed to evaluate for learning and repeatability for the thresholded acuity at each eccentricity. RESULTS: The ETDRS acuity averaged 1.15+/-0.37 arc min minimum angle of resolution (MAR) with best correction (20/23 equivalence). At fixation, the thresholded acuity for high-contrast targets paralleled the ETDRS acuity and averaged 1.75+/-0.85 arc min MAR (20/35 equivalence), and declined with increasing eccentricity in a linear fashion to 5.81+/-3.97 arc min (20/116 equivalent) at 10 degrees eccentricity. Linear regression showed Vmar=1.74+0.330 (*) eccentricity in degrees (R (2)=0.966, P<0.0001). Testing time required approximately 8-10 min per eye. Repeated testing showed only minimal learning experience at the most peripheral locations. The test-retest 95% confidence limits of difference measured 1.12 arc mins MAR at fixation (64% of the mean) and remained approximately the same proportion to the mean thresholded acuity outwards to 10 degrees eccentricity. CONCLUSION: The methodology seems rapid and reliable for measuring discriminatory visual function of optotype targets throughout the central 20 degrees diameter visual field.

Interactive, computer-based, self-reported, visual function questionnaire: the PalmPilot-VFQ.

PURPOSE: To evaluate the testing performance, reliability, and validity of a self-administered visual function questionnaire designed for a Palm Pilot in comparison with the interviewer-administered-National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) (interviewer-NEI-VFQ-25) and self-administered-NEI-VFQ-25 (self-NEI-VFQ-25). METHOD: The interviewer-NEI-VFQ-25 was administered to 135 sequential patients who visited a retina clinic, followed on separate days by the Palm Pilot-Visual Function Questionnaire (PalmPilot-VFQ) and self-NEI-VFQ-25. Rasch analysis of ordinal difficulty ratings for the PalmPilot-VFQ was used to estimate interval measures of perceived visual ability. Reliability was determined by calculating Cronbach's alpha and test-retest intraclass correlation coefficients (ICCs). Concurrent validity was determined by calculating correlations of the PalmPilot-VFQ score with that of a general vision question. For evaluating convergent validity, the PalmPilot-VFQ was compared with the interviewer-NEI-VFQ-25, habitual-correction visual acuity (HCVA), and with two visual analogue scale (VAS) questions. Performance time and testability were compared among the three questionnaires. RESULTS: Rasch analysis eliminated two items in the PalmPilot-VFQ due to poor-fit statistics. The final items showed internal consistency (Cronbach's alpha=0.89) and test-retest reliability (ICC=0.79), as well as an excellent separation index (3.23 and 4.01) for item parameters with significant concurrent correlation (P<0.0001). On evaluating convergent validity, the PalmPilot-VFQ showed strong correlations with interviewer-NEI-VFQ-25, with the HCVA of the better-seeing eye, and with the VAS questions (P=0.0001). Ninety percent of the 135 patients (HCVA >20/200 in the better-seeing eye) could perform the PalmPilot-VFQ with their habitual correction or high-plus spectacles, but in significantly less time than either interviewer-NEI-VFQ-25 or self-NEI-VFQ-25 (P<0.0001). CONCLUSION: The PalmPilot-VFQ seems to be a reliable, valid, interactive, computer-based, self-administered questionnaire that can be used routinely by physicians to evaluate functional vision disability in populations with a high prevalence of macular disease.

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration.

PURPOSE: This pilot study was undertaken to examine the relationships between clinical measures of visual function and anatomic changes occurring in the eyes treated with bevacizumab for choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). METHODS: A retrospective review was conducted for 50 eyes that had been treated with at least three injections of bevicizumab for CNV due to AMD, and followed for at least 6 months. Vision outcomes included best-corrected ETDRS chart acuity, scored by best-line read (ETDRS line) and by total letters read (ETDRS letter), and two measures obtained from central acuity perimetry with 98% Michelson contrast targets, the best acuity within 6 degrees of fixation (BA6 degrees ), and global macular acuity (GMA), representing a weighted average of the acuities thresholded at all intercepts within a 10 degrees radius of fixation. Assessment of anatomic outcomes included fibrosis, atrophy, and subretinal hemorrhage grading on fundus photography, CNV size, pigment epithelial detachment (PED) size and grading of CNV leakage on fluorescein angiography, and central retinal PED, and subretinal fluid (SRF) thickness on optical coherence tomography. RESULTS: Logistic regression analysis showed an association between the vision outcomes of EDTRS letter and BA6 degrees with the change in SRF thickness (R (2): 0.47 and 0.35, respectively). The outcome of the vision measurement of GMA was associated with the change in SRF thickness, in CNV thickness, and in CNV fibrosis grade (R (2): 0.34). No association was noted between the outcomes of ETDRS line with the change in any anatomic outcomes. CONCLUSION: Acuity perimetry outcomes in this study seemed to offer improved understanding of the relationship between the vision outcomes and the measured anatomic changes. It seemed that neither ocular coherence tomography nor fluorescein angiography alone offered sufficient morphologic markers for prediction of functional outcomes.

Visual predictive value of the ocular trauma score in children.

BACKGROUND/AIMS: To analyse the predictive value of ocular trauma score (OTS) in open-globe injuries in children. METHODS: Thirty open-globe injuries in children 16 years or younger treated at our facilities were included. OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment and afferent pupillary defect) were determined at the initial presentation and converted into the OTS categories as performed in the OTS Study. The distribution of the percentage of final visual acuity in each category was compared between the OTS study and our study. RESULTS: Compared with the OTS Study, in our group no light perception ratios were lower in the first two categories (p = 0.012, p<0.001, respectively); light perception/hand motion, and 1/100-19/100 ratios were higher in categories 2 and 3 (p<0.001 each), and the 20/200 to 20/50 ratio was lower in categories 3, 4 and 5 (p<0.001, p<0.001, p = 0.028, respectively). The ratio of >or=20/40 was lower in categories 2 and 3 (p<0.001, each) but higher in category 4 (p<0.001). In this study, the distribution of the percentage of final visual acuity in various OTS categories was found to be different between our study and the OTS study. CONCLUSION: In the paediatric population, OTS calculations might have limited value as predictors of visual outcome.