Search

Background/Objectives: This study evaluated the clinical outcomes of selective retina therapy (SRT) for treating central serous chorioretinopathy. A fundus image-based titration method was used for laser irradiation. Methods: This retrospective cohort study included 29 eyes (29 patients) that underwent SRT for CSC. Both the pulse energy and number of micropulses were adjusted according to the fundus image. Mean best-corrected visual acuity (BCVA), central foveal thickness (CFT), and subretinal fluid (SRF) height were measured 1, 2, 3, 4, and 6 months after SRT. Mean deviation (MD) was measured using microperimetry at 3 and 6 months post-treatment. Results: At 6 months after SRT treatment, SRF was completely resolved in 89.7% of cases (26/29 eyes). The mean Snellen BCVA significantly improved from 0.34 ± 0.31 logMAR (logarithm of the minimum angle of resolution) (20/40) at baseline to 0.24 ± 0.24 logMAR (20/32) at 6 months (p = 0.009). The 0.1 improvement in mean BCVA is equivalent to a 5-letter gain on the ETDRS chart. The mean CFT decreased significantly from 309.31 ± 81.6 μm at baseline to 211.07 ± 50.21 μm at 6 months (p < 0.001). The mean SRF height also decreased significantly from 138.36 ± 56.78 μm at baseline to 23.75 ± 61.19 μm at 6 months (p < 0.001). The mean MD was improved from −1.56 ± 1.47 dB at baseline to −1.03 ± 2.43 dB at 6 months (p = 0.07) after treatment. Conclusions: SRT using fundus image-based titration can yield favorable functional and anatomical outcomes in the treatment of CSC. [ABSTRACT FROM AUTHOR]

Introduction: Degeneration in choroideremia, unlike typical centripetal photoreceptor degenerations, is centred temporal to the fovea. Once the fovea is affected, the nasal visual field (temporal retina) is relatively spared, and the preferred retinal locus shifts temporally. Therefore, when reading left to right, only the right eye reads into a scotoma. We investigate how this unique property affects the ability to read an eye chart. Methods: Standard‐ and low‐luminance visual acuity (VA) for right and left eyes were measured with the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Letters in each line were labelled by column position. The numbers of letter errors for each position across the whole chart were summed to produce total column error scores for each participant. Macular sensitivity was assessed using microperimetry. Central sensitivity asymmetry was determined by the temporal‐versus‐nasal central macular difference and subsequently correlated to a weighted ETDRS column error score. Healthy volunteers and participants with X‐linked retinitis pigmentosa GTPase regulator associated retinitis pigmentosa (RPGR‐RP) were used as controls. Results: Thirty‐nine choroideremia participants (median age 44.9 years [IQR 35.7–53.5]), 23 RPGR‐RP participants (median age 30.8 years [IQR 26.5–40.5]) and 35 healthy controls (median age 23.8 years [IQR 20.3–29.0]) were examined. In choroideremia, standard VA in the right eye showed significantly greater ETDRS column errors on the temporal side compared with the nasal side (p = 0.002). This significantly correlated with greater asymmetry in temporal‐versus‐nasal central macular sensitivity (p = 0.04). No significant patterns in ETDRS column errors or central macular sensitivity were seen in the choroideremia left eyes, nor in RPGR‐RP and control eyes. Conclusion: Difficulty in tracking across lines during ETDRS VA testing may cause excess errors independent of true VA. VA assessment with single‐letter optotype systems may be more suitable, particularly for patients with choroideremia, and potentially other retinal diseases with asymmetric central macular sensitivity or large central scotomas including geographic atrophy. [ABSTRACT FROM AUTHOR]

The aim of the study is to compare macular sensitivity and retinal thickness in patients with long-term type 1 diabetes mellitus (DM1) without diabetic retinopathy (DR) after 5 years of follow-up. Thirty-two eyes from 32 long-term DM1 patients without DR were included. All participants underwent a complete ophthalmological examination, including microperimetry and spectral domain optical coherence tomography (SD-OCT). The data were compared with results from 5 years prior. The mean age of the DM1 patients was 43.19 ± 10.17 years, with a mean disease duration of 29.84 ± 8.98 years and good glycemic control. In 2023, patients exhibited a significantly worse best corrected visual acuity (BCVA) compared to 2018 (p < 0.001). DM1 patients did not show statistically significant changes in macular sensitivity over the 5-year follow-up period. Macular integrity showed significant differences between the two time points (p = 0.045). Retinal thickness showed significant differences, particularly in inner retinal layers (IRL) across most of the ETDRS areas. Long-term DM1 patients without DR lesions showed worsened macular integrity and a lower BCVA in 2023. Additionally, they displayed significant alterations in retinal thicknesses, especially in the IRL, between 2018 and 2023. These findings suggest that even in the absence of visible DR, long-term DM1 patients may experience subclinical retinal changes and functional deterioration over time, highlighting the importance of regular monitoring for the early detection and management of potential complications. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to compare phacovitrectomy (phacoPPV) to lens-sparing pars plana vitrectomy (PPV) with respect to macular perfusion, thickness, and sensitivity in phakic patients with rhegmatogenous retinal detachment. Patients and methods This is a prospective, comparative, nonrandomized, interventional study that included 31 phakic eyes with primary rhegmatogenous retinal detachment. The patients were divided into two groups according to the preoperative lens status: group A who had significant cataract and group B who did not have significant cataract. Group A included 17 eyes for which phacoPPV was performed, while group B included 14 eyes for which lens-sparing PPV was performed. All patients were preoperatively evaluated clinically and with A-scan ultrasonography and were followed up for 4 months after surgery. Optical coherence tomography angiography (OCTA) and microperimetry were done at 2 and 4 months, postoperatively. Results The OCTA showed that the lens-sparing PPV was associated with significantly larger foveal avascular zone area (0.4±0.2 mm2) compared to the phacoPPV (0.2±0.1 mm2) at 2 months (P=0.048), as well as at 4 months (0.4±0.1 mm2vs. 0.2±0.1 mm2, respectively, P=0.044). However, the foveal avascular zone perimeter showed no statistically significant differences between the two groups at 2 and 4 months postoperatively. At 2 months, the deep vascular plexus (DVP) parafoveal vessel density was statistically significantly higher in the phacoPPV group (47.9±4.7%) compared to the PPV group (36.4±11.9%) (P=0.048), while at 4 months it was the DVP foveal vessel density that showed a significantly higher mean in the phacoPPV group (35.4±11.9%) compared to the PPV group (20.3±16.1%) (P=0.036). No other statistically significant intergroup differences were found with respect to other parameters for macular perfusion, and other DVP parameters. Similarly, the macular sensitivity, as well as the ganglion cell complex, and the central subfield thicknesses were comparable between the two groups. The visual outcome was also comparable at 2 and 4 months between the two groups. Conclusion PhacoPPV and lens-sparing vitrectomy were comparable with respect to OCTA, microperimetry, and visual acuity. The limited differences are too preliminary and the decision to do phacoPPV rather than lens-sparing PPV needs to be based on other determinants like the presence of preoperative lens opacity.

AIM: To investigate macular microperimetry in patients with early primary open angle glaucoma (POAG) using a new custom-made pattern, and analyze the characteristics of macular sensitivity. METHODS: This case-control study included 38 patients with POAG, who were divided into pre-perimetric glaucoma (18 eyes of 18 patients), early-stage (20 eyes of 20 patients), and control (20 eyes of 20 patients) groups. All subjects underwent standard 24-2 humphrey visual field test. An MP-3 microperimeter with a new custom-made pattern (28 testing points distributed in four quadrants, covering the central 10° of the retina) was used to evaluate macular sensitivity. Ganglion cell complex (GCC) thicknesses were examined using an RS-3000 Advance OCT system. The features of structure and function were analysed per quadrant. RESULTS: The pre-perimetric glaucoma group had significantly lower inferior hemifield macular sensitivity compared to controls (P

Purpose: To assess macular sensitivity and fixation pattern obtained by microperimetry and ganglion cell complex (GCC) obtained by optical coherence tomography (OCT) in cases with unilateral amblyopia and to compare with control. Methods: The study was conducted with 30 patients with amblyopia, aged 5–18 years, and 30 control eyes of healthy children in the same age group. Participants underwent full ophthalmological examination. Macular sensitivity, stabilization, and location of fixation values were measured using microperimetry. The GCC values were obtained by OCT. Measurements were compared between amblyopic eyes, fellow eyes, and controls. Any correlation between GCC, macular sensitivity, and fixation was investigated. P < 0.05 was considered statistically significant. Results: The mean age was 10.13 ± 3.49 years in the amblyopia group and 11.53 ± 2.7 years in the control group. Three groups were formed: amblyopic eyes (Group 1, n = 30), fellow eyes (Group 2, n = 30), and control eyes (Group 3, n = 30). The macular sensitivity values were found highest in the control group (P = 0.007). Bivariate contour ellipse area 1, which is the numerical value of fixation stabilization, was measured to be the lowest in the control group (P < 0.0001). In the analysis among the three groups, no significant difference was observed in terms of the GCC (P = 0.229). In the correlation analyses, a significant correlation was detected between macular sensitivity and GCC values in amblyopic eyes. Conclusion: In amblyopic eyes, the macular sensitivity was significantly lower and the GCC thickness was found to be in a positive correlation with macular sensitivity.

Purpose: To assess macular sensitivity and fixation pattern obtained by microperimetry and ganglion cell complex (GCC) obtained by optical coherence tomography (OCT) in cases with unilateral amblyopia and to compare with control. Methods: The study was conducted with 30 patients with amblyopia, aged 5–18 years, and 30 control eyes of healthy children in the same age group. Participants underwent full ophthalmological examination. Macular sensitivity, stabilization, and location of fixation values were measured using microperimetry. The GCC values were obtained by OCT. Measurements were compared between amblyopic eyes, fellow eyes, and controls. Any correlation between GCC, macular sensitivity, and fixation was investigated. P < 0.05 was considered statistically significant. Results: The mean age was 10.13 ± 3.49 years in the amblyopia group and 11.53 ± 2.7 years in the control group. Three groups were formed: amblyopic eyes (Group 1, n = 30), fellow eyes (Group 2, n = 30), and control eyes (Group 3, n = 30). The macular sensitivity values were found highest in the control group (P = 0.007). Bivariate contour ellipse area 1, which is the numerical value of fixation stabilization, was measured to be the lowest in the control group (P < 0.0001). In the analysis among the three groups, no significant difference was observed in terms of the GCC (P = 0.229). In the correlation analyses, a significant correlation was detected between macular sensitivity and GCC values in amblyopic eyes. Conclusion: In amblyopic eyes, the macular sensitivity was significantly lower and the GCC thickness was found to be in a positive correlation with macular sensitivity. [ABSTRACT FROM AUTHOR]

Twenty-seven glaucoma patients (54 eyes in total) with well-controlled intraocular pressure were trained with binocular virtual reality visual software for 3 months to investigate whether virtual reality visual perceptual plastic training promotes macular retinal structure and macular function recovery in glaucoma patients. The thickness of peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell layer-inner plexiform layer (mGCIPL), and mean macular sensitivity (mMS) were evaluated 3 months after training. The mean value of pRNFL thickness in glaucoma patients did not change significantly (Z = 0.642, p = 0.521), nor did the mean value (t = 1.916, p = 0.061) and minimum value (Z = 1.428, p = 0.153) of mGCIPL after 3 months. However, the significant increases were found in superior temporal mGCIPL thickness (t = 2.430, p = 0.019) as well as superior mGCIPL thickness (t = 2.262, p = 0.028). Additionally, the mMS was increased (Z = 2.259, p < 0.05), with the inferior square to be a more pronounced mMS increase (Z = 2.070, p = 0.038). In conclusion, virtual reality visual perceptual plastic training can increase the thickness of retinal ganglion cells complexes in the macular area of glaucoma patients and improve the macular function of the corresponding area. Clinical Trial registration number: ChiCTR1900027909. [ABSTRACT FROM AUTHOR]

Abstract Background Patients with central retinal vein occlusion (CRVO) and macular edema often are treated by intravitreal ranibizumab injection (IRI). The role of changes in macular sensitivity in the positive effects of IRI on visual functions is unclear. Therefore, we assessed the relationship between macular sensitivity and improvement of visual functions. Methods We included 15 eyes of 15 patients with treatment-naïve CRVO and followed patients for 6 months after pro re nata IRI. IRI was repeated if the central macular thickness was greater than or equal to 300 µm. Microperimetry-3 was used to measure macular sensitivity within the central 1-mm, 3-mm, and 6-mm fields before and monthly for 6 months after IRI. Results IRI significantly improved mean macular sensitivity over time within the central 1-mm, 3-mm, and 6-mm fields (all P 0.3). The mean macular sensitivity before IRI showed correlations with the improvement of macular sensitivity in every field. Conclusion These findings suggest that IRI improves macular sensitivity in patients with CRVO and macular edema independent of any improvement in BCVA and that macular sensitivity before treatment is associated with improvement of macular sensitivity after treatment.

Background: Patients with central retinal vein occlusion (CRVO) and macular edema often are treated by intravitreal ranibizumab injection (IRI). The role of changes in macular sensitivity in the positive effects of IRI on visual functions is unclear. Therefore, we assessed the relationship between macular sensitivity and improvement of visual functions.Methods: We included 15 eyes of 15 patients with treatment-naïve CRVO and followed patients for 6 months after pro re nata IRI. IRI was repeated if the central macular thickness was greater than or equal to 300 µm. Microperimetry-3 was used to measure macular sensitivity within the central 1-mm, 3-mm, and 6-mm fields before and monthly for 6 months after IRI.Results: IRI significantly improved mean macular sensitivity over time within the central 1-mm, 3-mm, and 6-mm fields (all P < 0.001). None of the fields showed significant differences in the change of mean macular sensitivity between patients with little improvement in best corrected visual acuity (BCVA; i.e., in patients with a change in logarithm of the minimum angle of resolution [logMAR] BCVA < 0.3) and those with marked improvement in BCVA (change in logMAR BCVA > 0.3). The mean macular sensitivity before IRI showed correlations with the improvement of macular sensitivity in every field.Conclusion: These findings suggest that IRI improves macular sensitivity in patients with CRVO and macular edema independent of any improvement in BCVA and that macular sensitivity before treatment is associated with improvement of macular sensitivity after treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant. Methods Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity. Results There was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p

Purpose: To compare the performance of focal electroretinogram (FERG) and fast mesopic microperimetry in evaluating macular function of intermediate age‐related macular degeneration (iAMD) subjects with preserved visual acuity. Methods: Cross‐sectional, observational study. Participants with drusen >125 µm and VA ≥80 ETDRS letters and age‐ and sex‐comparable healthy subjects were consecutively enrolled in the study. Three photopic FERG recordings of the central 9° of the macula with luminance modulated stimuli flickering at 42.5 Hz and a fast mesopic microperimetry with a custom pattern of 3 central (CS) and 3 paracentral (pCS) stimuli at 1.2° and 6° from fixation were acquired. Results: Overall, 112 eyes of 77 participants (age 73.0 ± 7.1 years, 47 iAMD eyes) were analysed. Mean FERG amplitude, CS and pCS (all p < 0.05) were lower in the iAMD group. A significant association was observed between FERG amplitude and iAMD (OR 9.58, p < 0.001) in multiple logistic regression analysis. Z‐scores of FERG were lower than microperimetry in iAMD (p = 0.002) but not for healthy participants. AUC of the ROC curve was greater for FERG than microperimetry (0.895 versus 0.644 and 0.675, both p < 0.05). Conclusion: Focal ERG objectively measures a cumulative response originating from the photoreceptor‐RPE complex of the central 9° of the macula and demonstrated high accuracy in identifying decreased central macular function in iAMD patients with preserved visual acuity, performing better than fast mesopic microperimetry. Focal ERG should be considered a reliable technique for measuring retinal sensitivity of iAMD patients. [ABSTRACT FROM AUTHOR]

Abstract Background A majority of multiple sclerosis patients experience visual impairment, often as the initial presenting symptom of the disease. While structural changes in the retinal nerve fiber layer and optic nerve have demonstrated correlations with brain atrophy in multiple sclerosis using magnetic resonance imaging, a non-invasive, cost-effective, and clinically efficacious modality to identify early damage and facilitate prompt therapeutic intervention to slow the progression of multiple sclerosis and its ocular manifestations, is still urgently needed. In this study, we sought to determine the role of macular sensitivity measured by microperimetry in the detection of subclinical multiple sclerosis-related retinal damage and visual dysfunction. Methods This cross-sectional observational case-control study involved population-based samples of multiple sclerosis patients and age-, race-, and gender-matched healthy control subjects. Among the key criteria for the multiple sclerosis patients were diagnosis by the McDonald criteria, visual acuity greater than 20/25, and no history of optic neuritis. Macular sensitivity and average macular thickness were measured in all subjects using microperimetry and spectral-domain optical coherence tomography, respectively. Pearson correlation coefficients were measured using bivariate correlations. Sample means, mean differences, and 95% confidence intervals were calculated using independent sample t-tests. Results Twenty-eight eyes from 14 MS patients and 18 eyes from 9 control subjects were included. Mean macular sensitivity of control subjects and multiple sclerosis patients in decibels was 18.2 ± 0.4 and 16.5 ± 0.4, respectively, corresponding to a mean difference of 1.7 (95% CI, 1.1–2.4; P

Background: Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant.Methods: Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.Results: There was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p < 0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r = 0.469; p = 0.012).Conclusions: Macular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD. (338 words). [ABSTRACT FROM AUTHOR]

María Elena Rodríguez González-Herrero,1 Marcos Ruiz,1 Francisco Javier López Román,2 José María Marín Sánchez,1 Joan Carles Domingo3 1Service of Ophthalmology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; 2Department of Exercise Physiology, Faculty of Health Sciences, San Antonio Catholic University of Murcia (UCAM), Murcia, Spain; 3Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain Objective: There is little evidence of real-life outcomes of dietary supplementation with high-dose docosahexaenoic acid (DHA) and carotenoids in patients with diabetic retinopathy (DR). We assessed the effect of supplementation with DHA triglyceride (1,050 mg/d) + xanthophyll carotenoid multivitamin on macular function in nonproliferative DR.Methods: Asymptomatic patients with nonproliferative DR were included in a prospective controlled study and assigned (1:1) to the DHA supplementation group or the control group. Macular sensitivity and macular integrity area were the main outcome measures. Functional vision measures (macular function [MAIA™ CenterVue], best-corrected visual acuity), structural retinal measures (central subfield macular thickness), and biochemical parameters (plasma total antioxidant capacity, DHA content of the erythrocyte membrane, and plasma IL-6) were evaluated at baseline and after 45 and 90 days of DHA supplementation.Results: The study included 24 patients (48 eyes) (12 patients, 24 eyes in each group). Baseline clinical characteristics of patients in both groups were similar. Macular sensitivity increased from a mean (SD) of 25.9 (2.4) dB at baseline to 27.3 (2.3) dB at 90 days (P=0.030) in the DHA group only (between-group differences P

Abstract Background To evaluate the macular sensitivity changes after half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSCR). Methods Eighteen patients (26 eyes) with chronic CSCR were recruited in the same hospital between April 2011 and December 2012. All patients were treated with one session of half-dose PDT after complete ophthalmic examination. Macular sensitivity examination was performed at baseline and 1, 3 and 6 months post-treatment. Mean sensitivity (MS) of the central 10 degrees (10°) and 4 degrees (4°), mean deviation (MD) and pattern standard deviation (PSD) on automated static perimetry (Humphrey Field Analyzer II-750) were used for analysis. Results There was significant improvement of the 10°MS from baseline (29.76 ± 1.51 dB) to 1 month (31.74 ± 1.56 dB), 3 months (31.51 ± 1.38 dB) and 6 months (31.19 ± 1.61 dB) after treatment (P

Aim: The aim is to study the correlation of macular thickness and sensitivity in type 2 diabetes mellitus patients. Materials and Methods: A cross-sectional comparative study was done on 77 eyes with diabetic retinopathy. Patients were divided into three groups as follows: Group 1 – Diabetic retinopathy without maculopathy, Group 2 – Diabetic maculopathy without clinically significant macular edema (CSME), and Group 3 – CSME. Microperimetry was used to assess macular sensitivity, and optical coherence tomography (OCT) was used to measure retinal thickness. Comparison of retinal sensitivity and thickness was done between groups. Correlation of these parameters to duration of diabetes was also done. Results: The mean macular sensitivity (in dB) in Groups 1, 2, and 3 was 11.57, 11.51, and 8.03, respectively. The mean central macular thickness in Groups 1, 2, and 3 was 199.33, 208.62, and 334.25 μm, respectively. There was statistically significant difference in macular thickness and in macular sensitivity between Groups 1 and 3 (P < 0.001) and between Groups 2 and 3 (P < 0.001). This difference was not statistically significant between Groups 1 and 2 (P > 0.09). Macular sensitivity had a moderate correlation with macular thickness, which was statistically significant (P < 0.001). Conclusions: Macular sensitivity was found to decrease with increasing macular thickness.

Purpose: To investigate the associations between macular sensitivity (MS) and fixation in pseudophakic children after congenital cataract surgery. Materials and Methods: In total 55 pseudophakic eyes and 28 healthy phakic eyes were included in this cross-sectional study. MS and fixation stability in term of 95% bivariate contour ellipse area (BCEA) were assessed with a Macular Integrity Assessment microperimeter. Central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) was measured with optical coherence tomography. MS inside and outside the 95% BCEA was compared. Influencing factors for the difference in MS between the two regions (ΔMS) were assessed. Results: The overall MS was significantly lower in pseudophakic eyes than in the controls (P <.001). In the pseudophakic group, fixation stability was stable/relatively unstable/unstable in 69.1%/16.4%/14.5% of eyes, and their MS was 27.60 ± 2.56, 25.02 ± 3.82, and 20.50 ± 7.15 dB, respectively. The unstable subgroup had significantly worse MS than the stable subgroup (P <.001). Among pseudophakic eyes, the MS inside the 95% BCEA (fixation preferred region) was significantly greater than that outside this region (P =.048), and it was more correlated with BCVA than that of the entire macula. The ΔMS became greater in those pseudophakic eyes with worse fixation stability (P <.001) and longer axial length (P =.002). Backward stepwise multiple linear regression also revealed 95%BCEA and axial length had significant influences on ΔMS (R2 = 0.289, P <.001). Conclusion: MS was lower in pseudophakic eyes with poor fixation. Macular sensitivity inside and outside the fixation preferred region was different in pseudophakic children after congenital cataract surgery, and this difference increased with longer axial length and poorer fixation. [ABSTRACT FROM AUTHOR]

Background: We aimed to measure and correlate inner retinal layer (IRL) thickness and macular sensitivity by optical coherence tomography (OCT) and by microperimetry, respectively, in type 1 diabetes mellitus patients (DM1) without diabetic retinopathy (DR). Methods: Fifty-one DM1 patients and 81 age-matched healthy subjects underwent measurement of the axial length (AL), retinal thickness in the macular ETDRS areas by swept source (SS)-OCT and macular sensitivity by microperimeter. Results: The total retinal and IRL thicknesses were thicker in the DM1 group (p < 0.05) in practically all ETDRS areas, and they had a generalized decrease in sensitivity (p < 0.05) in 9 areas between both groups. There was a significant negative correlation between retinal sensitivity and age in all areas and in visual acuity (VA) in 5 out of the 9 areas for DM1 patients. Only a mild negative correlation was observed between retinal sensitivity in the 5° nasal inner (5NI) area and in IRL thickness in the temporal inner (TI) area (−0.309 with p = 0.029) in the DM1 group. Conclusion: Aging and disease evolution in DM1 patients without DR signs generate a decrease in retinal sensitivity. There was a direct relationship between retinal sensitivity and macular thickness in the DM1 group.

Aim The aim of this study was to correlate the visual field changes in the central macular area with the areas of capillary nonperfusion seen in fluorescein angiogram in patients with nonproliferative diabetic retinopathy (NPDR). Patients and methods This study included 40 eyes of 32 patients with NPDR attending the Ophthalmic Outpatient Clinic of El-Minia University Hospital during the period from January 2012 to July 2013. All patients were subjected to automated perimetry using a Topcon perimeter. A full-threshold strategy was applied for the central 10° field (program 10–2) fluorescein angiography using the IMAGE Net 2000 fundus camera. Results This study included 40 eyes of 32 patients between 50 and 70 years of age with a mean of 59.3 ± 7.6 years. Of them, there were 12 (37.5%) male and 20 (62.5%) female patients. All patients were noninsulin-dependent diabetic patients with a mean duration of 16.6 ± 5.4 years; 20 (62.5%) patients were hypertensive and 12 (37.5%) were normotensive. Twenty eyes had a rate of 0 dB corresponding to areas of capillary nonperfusion. Sixteen eyes showed a rate of 0 dB less than the areas of capillary nonperfusion. Four eyes showed relatively good retinal sensitivity (rate of 0 dB = 0) despite the presence of definite areas of capillary nonperfusion. The mean sensitivity in these areas ranged between 10.38 ± 1.47 and 12.91 ± 1.43 dB. Conclusion There is a significant correspondence between macular capillary nonperfusion and central field sensitivity in patients with NPDR.

Purpose: To examine retinal sensitivity in patients on hydroxychloroquine (HCQ) with no evidence of retinopathy. Materials and methods: Seventy patients on HCQ and 30 healthy control subjects were included prospectively. All subjects underwent complete ophthalmic examination including best corrected visual acuity, tonometry, colour vision testing, biomicroscopy of anterior segment, dilated fundoscopy, 10-2 visual field testing, and spectral domain optical coherence tomography. The patients and control subjects who met the inclusion criteria and had normal tests underwent microperimetry (MP) testing. First, all patients were compared with the control group. Secondly, patients were divided into three sets of groups based on (1) duration of use ≤5 years (DOU≤5) and >5 years (DOU>5), (2) daily dose ≤5 mg/kg/day (DD≤ 5) and >5 mg/kg/day (DD>5), and (3) a cumulative dose ≤1000 gr (CD≤ 1000) and >1000 gr (CD>1000), and these groups were compared to each other and to the control group. A correlation analysis was also performed between MP sensitivity and DOU, DD, and CD. Results: Seven patients on HCQ showing visual field abnormality were excluded which yielded 63 patients and 30 control subjects for the final analysis. We observed significant differences only in the central region but not in the paracentral or peripheral regions on MP in HCQ users. The median MP sensitivities in the central region were significantly lower in all the patients [84 (63-100) dB], and in subgroups of DOU >5 [84 (63-99) dB], DD >5 [82 (63-97) dB] and CD >1000 [82 (63-92) dB] when compared to controls [89.7 (83-98) dB]. A statistically significant correlation was found only between DD and MP sensitivity in the central region (r = −0.263; p = 0.02). Conclusions: MP sensitivities in the central macula were significantly lower in patients taking HCQ for more than 5 years, at a daily dose more than 5 mg per day, and with a cumulative dose over 1000 gr. Further research investigating long-term follow-up changes in MP sensitivities is needed to determine cutoff values for early retinal toxicity. [ABSTRACT FROM AUTHOR]

Objective: There is little evidence of real-life outcomes of dietary supplementation with high-dose docosahexaenoic acid (DHA) and carotenoids in patients with diabetic retinopathy (DR). We assessed the effect of supplementation with DHA triglyceride (1,050 mg/d) +xanthophyll carotenoid multivitamin on macular function in nonproliferative DR. Methods: Asymptomatic patients with nonproliferative DR were included in a prospective controlled study and assigned (1:1) to the DHA supplementation group or the control group. Macular sensitivity and macular integrity area were the main outcome measures. Functional vision measures (macular function [MAIA™ CenterVue], best-corrected visual acuity), structural retinal measures (central subfield macular thickness), and biochemical parameters (plasma total antioxidant capacity, DHA content of the erythrocyte membrane, and plasma IL-6) were evaluated at baseline and after 45 and 90 days of DHA supplementation. Results: The study included 24 patients (48 eyes) (12 patients, 24 eyes in each group). Baseline clinical characteristics of patients in both groups were similar. Macular sensitivity increased from a mean (SD) of 25.9 (2.4) dB at baseline to 27.3 (2.3) dB at 90 days (P=0.030) in the DHA group only (between-group differences P,0.19). The macular integrity index decreased from 71.2 (33.2) at baseline to 63.5 (36.4) at 45 days and to 51.6 (35.9) at 90 days (P=0.002) in the DHA group only (between-group differences P,0.05). Best-corrected visual acuity and central subfield macular thickness did not vary significantly in any of the comparisons and in none of the groups. DHA content of erythrocyte membrane and total antioxidant capacity levels increased significantly only in the DHA group. Plasma IL -6 levels decreased significantly only in the DHA group. Conclusion: In an early stage of DR, supplementation with high-dose DHA plus xanthophyll carotenoid multivitamin during 90 days was associated with a progressive and significant improvement of macular function measured by microperimetry. Biochemical changes supported the effect of DHA. [ABSTRACT FROM AUTHOR]

Background: To evaluate the macular sensitivity changes after half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSCR).Methods: Eighteen patients (26 eyes) with chronic CSCR were recruited in the same hospital between April 2011 and December 2012. All patients were treated with one session of half-dose PDT after complete ophthalmic examination. Macular sensitivity examination was performed at baseline and 1, 3 and 6 months post-treatment. Mean sensitivity (MS) of the central 10 degrees (10°) and 4 degrees (4°), mean deviation (MD) and pattern standard deviation (PSD) on automated static perimetry (Humphrey Field Analyzer II-750) were used for analysis.Results: There was significant improvement of the 10°MS from baseline (29.76 ± 1.51 dB) to 1 month (31.74 ± 1.56 dB), 3 months (31.51 ± 1.38 dB) and 6 months (31.19 ± 1.61 dB) after treatment (P < 0.001). The 4°MS was also significantly improved with half-dose PDT from baseline (28.96 ± 1.78 dB) to 1 month (32.41 ± 1.66 dB), 3 months (32.46 ± 1.50 dB) and 6 months (31.90 ± 1.84 dB) post-treatment (P < 0.001). MD was improved from baseline (-3.39 ± 0.89 dB) to 1 month (-1.96 ± 0.29 dB), 3 months (-1.94 ± 0.29 dB) and 6 months (-2.45 ± 0.13) post-treatment (P = 0.004). PSD also improved from 1.97 ± 0.24 dB at baseline to 1.47 ± 0.27 dB, 1.34 ± 0.24 dB, and 1.53 ± 0.24 dB (P = 0.001) at 1, 3 and 6 months after treatment, respectively.Conclusion: Macular sensitivity in CSCR can be improved by half-dose PDT, along with improvement of visual acuity and retinal thickness. The treatment outcome at 1 month may be a predictor of the final treatment response. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to correlate the visual field changes in the central macular area with the areas of capillary nonperfusion seen in fluorescein angiogram in patients with nonproliferative diabetic retinopathy (NPDR). Patients and methods This study included 40 eyes of 32 patients with NPDR attending the Ophthalmic Outpatient Clinic of El-Minia University Hospital during the period from January 2012 to July 2013. All patients were subjected to automated perimetry using a Topcon perimeter. A full-threshold strategy was applied for the central 10° field (program 10-2), and fluorescein angiography: using the IMAGE Net 2000TM fundus camera. Results This study included 40 eyes of 32 patients between 50 and 70 years of age with a mean of 59.3±7.6 years. Of them, there were 12 (37.5%) male and 20 (62.5%) female patients. All patients were noninsulin-dependent diabetic patients with a mean duration of 16.6±5.4 years; 20 (62.5%) patients were hypertensive and 12 (37.5%) were normotensive. Twenty eyes had a rate of 0dB corresponding to areas of capillary nonperfusion. Sixteen eyes showed a rate of 0dB less than the areas of capillary nonperfusion. Four eyes showed relatively good retinal sensitivity (rate of 0 dB=0) despite the presence of definite areas of capillary nonperfusion. The mean sensitivity in these areas ranged between 10.38±1.47 and 12.91±1.43dB. Conclusion There is a significant correspondence between macular capillary nonperfusion and central field sensitivity in patients with NPDR. [ABSTRACT FROM AUTHOR]

Objective: To study the macular sensitivity after half-dose verteporfin photodynamic therapy in patients with resolved central serous chorioretinopathy using the automated static perimeter. Methods: Prospective consecutive case study of 24 patients with resolved central serous chorioretinopathy was performed. The macular sensitivity was measured using a conventional automated static perimeter with the Swedish interactive threshold algorithm 10-2 and foveal threshold. Best corrected visual acuity, intraocular pressure, fundus examination, macular thickness, and volume were also examined. The mean macular sensitivities of the affected eyes and their normal fellow eyes were calculated and compared. P<0.05 was considered statistically significant. Results: The mean macular sensitivities of the affected eyes were lower than the normal fellow eyes with a statistically significant difference in all areas of the study (P<0.05). Best corrected visual acuity improved significantly from pretreatment (0.26±0.3 logMAR) to posttreatment (0.075±0.15 logMAR, P<0.05). Macular thicknesses in affected eyes were 230.66±67.34 μm and in the normal eyes were 238.33±92.26 μm (P=0.68). Macular volumes in affected eyes were 8.77±0.49 and in the normal eyes were 8.70±0.50 (P=0.60). These findings were not statistically significant. Conclusion: Eyes with resolved central serous chorioretinopathy after half-dose verteporfin photodynamic therapy had lower macular sensitivity than normal fellow eyes. These findings agreed well with the previous microperimetric studies. The conventional automated static perimeter can also be used when a microperimeter is not available. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate changes in macular sensitivity, as measured with microperimetry, among patients with maculopathy and stable visual acuity (VA). Methods: Macular sensitivity was assessed using the Spectral OCT/SLO™ microperimetry (OCT/SLO, Optos Plc., Dunfermline, UK) in 25 eyes (16 patients) with maculopathy and stable VA (<5 letters change in ETDRS score) at two consecutive clinic visits. To take the limits of the test-retest repeatability of the OCT/SLO into account, coefficient of repeatability (CoR) was employed to estimate the probability of the sensitivity changes being secondary to measurement noise. Results: The point sensitivity changes were statistically significant (Wilcoxon signed-rank test, P < 0.001). Seventy-seven points (11 %) out of a total of 700 sensitivity points had a genuine sensitivity change, with a mean increase of 8.6 ± 2.6 dB in 35 points and a mean decrease of 7.9 ± 2.2 dB in 42 points. Conclusions: Point-to-point change in macular sensitivity can be used as a biomarker of changes in disease activity in patients with maculopathy, and can be more accurate than either mean sensitivity or BCVA in detection of changes in macular function. The measurement variability should be considered when observing the local sensitivity changes. [ABSTRACT FROM AUTHOR]

In patients with branch retinal vein occlusion (BRVO) and macular edema, the relations among full-field electroretinogram (ffERG) parameters and parameters of retinal function or morphology remain uncertain. The objective of this study was to investigate the correlations between parameters of the ffERG, including the photopic negative response (PhNR), and retinal functional or morphological parameters in these patients. In 62 consecutive BRVO patients (mean age: 68.5 ± 10.6 years; 32 women and 30 men), the amplitude and implicit time of the a-wave cone, b-wave cone, 30 Hz flicker, and PhNR were calculated from the ffERG. Microperimetry was employed to measure the macular sensitivity within the central 4°, 10°, and 20° fields, while macular thickness and volume within these fields were measured by optical coherence tomography. Best-corrected visual acuity (BCVA) was determined on the logarithm of the minimum angle of resolution scale. The cone b-wave, 30 Hz flicker, and PhNR amplitudes showed a significant correlation with BCVA. In addition, the cone a-wave, cone b-wave, 30 Hz flicker, and PhNR amplitudes all showed a significant correlation with macular sensitivity within the central 4°, 10°, and 20° fields. Only the 30 Hz flicker amplitude showed a significant correlation with the macular thickness and volume within the 4°, 10°, and 20° fields, while the other ERG parameters did not. These findings suggest that PhNR may be a useful ERG parameter for evaluating inner retinal function in BRVO patients. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the therapeutic effect of topical unoprostone isopropyl (unoprostone) on patients with retinitis pigmentosa ( RP). Methods Forty patients with typical forms of RP were included in the study. Seventeen of 40 patients were treated with 0.12% topical unoprostone twice daily in a randomly selected eye. Patients underwent follow-up examinations every 3 months after treatment. The efficacy of the treatment was monitored by visual acuity and visual field measurement testing using the Humphrey Field Analyzer ( HFA: the central 10-2 programme). Moreover, 12 RP patients who were included this study and 12 normal subjects were evaluated in terms of their macular blood flow of both eyes after instillation of unoprostone using the laser speckle method. Results One year after treatment, the 'macular sensitivity', calculated by HFA as the average sensitivity of the central 12 points, was preserved in the fellow eyes as well as the unoprostone-treated eyes. On the other hand, that in the eyes of the control RP patient was significantly decreased. Moreover, there were significantly greater improvements of the 'macular sensitivity' in the unoprostone-treated eyes than the fellow eyes. The change ratios of macular blood flow obtained from both RP patients and normal subjects were significantly increased in both the treated and the fellow eyes. No severe side-effects were observed. Conclusions These results demonstrate that topical unoprostone might have a therapeutic efficacy in patients with RP as a consequence of the macular blood flow improvement as well as its direct neuroprotective effect. [ABSTRACT FROM AUTHOR]

The influence of retinal ischemia on changes of visual acuity, macular sensitivity, macular thickness, and macular volume is unclear after pars plana vitrectomy (PPV) for macular edema with branch retinal vein occlusion (BRVO). Twenty-three patients (23 eyes) with BRVO and macular edema underwent PPV. Retinal ischemia was evaluated from capillary non-perfusion on fluorescein angiography, and patients were classified as ischemic or nonischemic. Microperimetry was performed with a Micro Perimeter 1. Macular thickness and volume were measured by optical coherence tomography. Mean macular thickness within the central 4°, 10°, and 20° fields decreased significantly from before to 3 and 6 months after PPV (all P < 0.001). Likewise, total macular volume within the central 4°, 10°, and 20° fields decreased significantly from before to 3 and 6 months after PPV (all P < 0.001). Best-corrected visual acuity (BCVA) improved significantly from before to 3 and 6 months after PPV ( P < 0.001). Furthermore, mean macular sensitivity within the central 4°, 10°, and 20° fields increased significantly from before to 3 and 6 months after PPV ( P = 0.002, P = 0.001, and P = 0.001, respectively). There were no significant differences in the trend profiles of macular thickness, macular volume, and BCVA between the ischemic and nonischemic groups. However, there was a significant difference in the trend profile of macular sensitivity within the central 4°, 10°, and 20° fields between the ischemic and nonischemic groups ( P = 0.017, P = 0.010 and P = 0.025, respectively). These findings suggest PPV may be more effective for improving macular sensitivity in ischemic than nonischemic BRVO. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effect of half-fluence rate indocyanine green angiography (ICGA)-guided verteporfin photodynamic therapy (PDT) on macular sensitivity (MS) in eyes with acute symptomatic central serous chorioretinopathy (CSC). Methods: Single-center consecutive case series by retrospective chart review. Sixteen eyes of 16 patients with acute CSC of 3 months duration or less, treated with half-fluence (25 mJ/cm) ICGA-guided verteporfin PDT were reviewed. At baseline and after 1, 3, and 6 months, all patients underwent MS testing of the central 20 °, MS testing of the retinal area covered by the PDT laser spot (MSLS), and evaluation of fixation stability (FS) for the central two degrees with the MP-1 microperimeter (Nidek, Vigonza, Italy). Results: Macular sensitivity improved from 16.4 ± 3.0 dB at baseline ( n = 16) to 18.2 ± 2.4 dB ( p < 0.001) at 1 month ( n = 16). At the 3-month ( n = 13) and 6-month ( n = 12) follow-up, MS stabilized at 19.5 ± 0.9 dB ( p = 0.21) and 19.0 ± 1.3 dB ( p = 0.74), without changes when compared to respective precedent follow-up. Mean MSLS improved from 12.9 ± 5.4 dB at baseline to 16.4 ± 4.9 dB ( p < 0.001) after 1 month. At the 3- and 6-month follow-up, MSLS was 19.1 ± 1.2 dB ( p = 0.1) and 18.9 ± 1.9 dB ( p = 0.8) respectively. Mean FS at the central 2 ° was 78.8 ± 30.4 % before treatment and 81.8 ± 29.5 % ( p = 0.7), 81.9 ± 27.5 % ( p = 0.7) and 83.6 ± 17.1 % ( p = 0.5) respectively 1, 3 and 6 months after treatment. Conclusion: Half-fluence (25 mJ/cm) PDT significantly increased mean MS of central 20 ° and mean MSLS, in eyes with acute symptomatic CSC. Fixation stability was stable at baseline and throughout 6 months of follow-up. [ABSTRACT FROM AUTHOR]

Purpose/Aim: To investigate the relations among best-corrected visual acuity (BCVA), macular sensitivity, macular thickness, and macular volume in patients with central retinal vein occlusion (CRVO) and macular edema. Materials and Methods: In 16 consecutive patients with CRVO (mean age: 71.9 ± 6.9 years; 10 women and six men), macular function was documented by microperimetry and BCVA was determined on the logarithm of the minimum angle of resolution scale. Macular thickness and macular volume were measured by optical coherence tomography (OCT), and mean macular sensitivity was calculated for each of nine macular subfields on the retinal map obtained by OCT. Results: BCVA was correlated with both macular thickness and macular volume in all nine subfields of the macular region. In contrast, macular sensitivity was correlated with both macular thickness and macular volume in six out of nine subfields (superior inner, superior outer, inferior inner, inferior outer, nasal inner, and nasal outer). The correlations were stronger in the nasal subfields than the other subfields. Conclusions: These findings suggest that evaluation of both visual acuity and macular sensitivity might be important when assessing visual function in CRVO patients with macular edema. [ABSTRACT FROM AUTHOR]

It has been reported that microperimetry is effective for evaluating macular function. The aim of this paper is to report and discuss changes seen in macular sensitivity and macular thickness after intravitreal injection of triamcinolone acetonide (IVTA) in two patients with macular edema and central retinal vein occlusion (CRVO). Two eyes from two patients with CRVO (one each with ischemic and nonischemic CRVO) received IVTA for macular edema. Microperimetry was performed to measure macular sensitivity within the central 4, 10, and 20 degree fields, while the macular thickness within these fields was measured by optical coherence tomography. The mean macular thickness and macular sensitivity within the central 4, 10, and 20 degree fields improved after IVTA in the patient with nonischemic CRVO. In contrast, the mean macular thickness and sensitivity within the central 4, 10, and 20 degree fields showed little change after IVTA in the patient with ischemic CRVO. IVTA improves macular sensitivity and morphology in nonischemic CRVO, so further evaluation of this treatment is justified. [ABSTRACT FROM AUTHOR]

Background: Cystoid macular edema (CME) is one of the common complications of retinitis pigmentosa (RP), and is responsible for patient complications such as blurred and reduced visual acuity and for subsequent atrophic changes in the fovea. The objective of this work was to evaluate the clinical efficacy of a topical dorzolamide (a carbonic anhydrase inhibitor) in CME associated with RP. Methods: Sixteen eyes of nine patients with CME secondary to typical forms of RP were included in the study. Baseline visual acuity, visual field, and optical coherence tomography (OCT) measurements were obtained for all patients. All patients used 1% dorzolamide three times daily in each eye. Patients underwent follow-up exams at 1, 3, and 6 months after treatment. The response to treatment was monitored by visual acuity and visual field measurement testing using the Humphrey Field Analyzer (HFA: the central 10-2 Program); in addition, foveal thickness was measured by OCT. Evaluation of macular sensitivity calculated by HFA as the average of 12 central points. Results: Thirteen (81.3%) of 16 eyes showed a clear decrease in retinal thickness after treatment. Evaluation of macular sensitivity, calculated by HFA as the average of 12 central points (with the exception of foveal point data, showed an improvement of more than 1.0 dB in nine (56.3%) of 16 eyes. Moreover, both the mean deviation value and macular sensitivity were significantly improved. No severe side-effects were seen in any of the patients examined. Conclusions: The results demonstrated that a topical dorzolamide is effective for the treatment of CME in patients with RP, and that the positive treatment effects last for up to 6 months. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study was to determine the relationship between vision-related quality of life (VRQOL) following the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and the macular sensitivity determined by microperimetry in patients with retinitis pigmentosa (RP). Methods: The Japanese version of the NEI VFQ-25 was used to assess the VRQOL of 30 patients with typical RP whose decimal visual acuity was ≥0.6. The mean retinal sensitivity within the central 10° was determined by fundus-related microperimetry (MP1). The correlation between the mean of the total composite NEI VFQ-25 score and MP1-determined macular sensitivity was determined. Results: Mean NEI VFQ-25 score was 69.4 ± 14.5 (range 34.6-90.3) in RP patients. There was a significant positive correlation between mean NEI VFQ-25 score and mean retinal sensitivity within 10° ( r = 0.673, P = 0.0003). Conclusion: The significant correlation between macular sensitivity and VRQOL measured with the NEI VFQ-25 indicates that sensitivity in the macular area is an important consideration in using VRQOL with RP patients. [ABSTRACT FROM AUTHOR]

PurposeTo evaluate the interexaminer and intraexaminer reliability of macular microperimetry using the microperimeter MP-1.MethodsParticipants: Fifteen healthy volunteers younger than 40 years of age (Group 1), 15 healthy subjects over 60 years (Group 2), and five patients with age-related macular degeneration (Group 3). Observation procedure: Two examiners (E1 and E2) measured, in random order, interexaminer (E2–E1a) reliability. Another examination was undergone by one of the examiners a week later to evaluate the intraexaminer (E1b–E1a) reliability. Main outcome measures: Macular sensitivity (mean threshold (decibel)) and stability of fixation were determined using MP1 microperimetry. Agreement was analysed by means of Bland–Altman plots and by the determination of the intraclass correlation coefficient.ResultsThe interexaminer (E2–E1a) and the intraexaminer (E1b–E1a) differences in the mean threshold values were not statistically significant (P=0.850, 95% confidence Interval (CI)=−0.265 to 0.319; P=0.246, 95% CI=−0.099 to 0.375, respectively). Limits of agreement and intraclass correlation coefficients also showed good agreement in each group.ConclusionsA good reliability was found for the mean threshold values in all the three groups, indicating examiner-independent measurements.Eye (2009) 23, 1052–1058; doi:10.1038/eye.2008.237; published online 1 August 2008 [ABSTRACT FROM AUTHOR]

The value of the MP-1 microperimeter in early diagnosis of pituitary tumours by detection of changes in macular sensitivity is described. A 21-year-old female presented with blurred vision in the right eye. Ophthalmic examination was unremarkable. Static perimetry of the central visual field (30°) was performed by use of a Humphrey automatic perimeter, and the retinal sensitivity of the 12 central degrees was measured by use of the MP-1. Static perimetry revealed a peripheral visual field defect without involvement of the macular region. The MP-1 revealed an important loss of sensitivity (3.4 ± 4.8 dB) in the central 12°. Magnetic resonance imaging revealed a pituitary adenoma with sellar and suprasellar extension. Three months after surgical removal, use of the MP-1 revealed complete recovery of the sensitivity (19.28 ± 2.5 dB), fixation location, and fixation stability of the right eye. In pituitary tumours, the presence of a sub-clinical form of macular involvement can be demonstrated and followed-up accurately by use of the MP-1. [ABSTRACT FROM AUTHOR]

Purpose To describe the efficacy of microperimetry (MP-1) in detecting early retinal toxicity as a result of chronic use of chloroquine and in monitoring the changes in macular sensitivity in an asymptomatic patient with best-corrected visual acuity of 20/20 bilaterally. Methods A 60-year-old woman presented for routine ocular examination with a medical history of severe rheumatoid arthritis, for which she had been receiving 3 mg chloroquine (CQ) per kilogram for the past 17 years. The patient was asymptomatic with best-corrected visual acuity of 20/20 bilaterally. Results Microperimeter showed loss of sensitivity in the macular region with a dense scotoma within the central 12 degrees (2.80 ± 4.7 dB right eye and 2.84 ± 4.7 dB left eye). CQ treatment was discontinued and substituted by Plaquenil. Conclusions Chloroquine retinal toxicity can be recognized in a subclincal form by the presence of early changes in macular sensitivity, detected by MP-1. [ABSTRACT FROM AUTHOR]

Background: We aimed to measure and correlate inner retinal layer (IRL) thickness and macular sensitivity by optical coherence tomography (OCT) and by microperimetry, respectively, in type 1 diabetes mellitus patients (DM1) without diabetic retinopathy (DR). Methods: Fifty-one DM1 patients and 81 age-matched healthy subjects underwent measurement of the axial length (AL), retinal thickness in the macular ETDRS areas by swept source (SS)-OCT and macular sensitivity by microperimeter. Results: The total retinal and IRL thicknesses were thicker in the DM1 group (p < 0.05) in practically all ETDRS areas, and they had a generalized decrease in sensitivity (p < 0.05) in 9 areas between both groups. There was a significant negative correlation between retinal sensitivity and age in all areas and in visual acuity (VA) in 5 out of the 9 areas for DM1 patients. Only a mild negative correlation was observed between retinal sensitivity in the 5° nasal inner (5NI) area and in IRL thickness in the temporal inner (TI) area (−0.309 with p = 0.029) in the DM1 group. Conclusion: Aging and disease evolution in DM1 patients without DR signs generate a decrease in retinal sensitivity. There was a direct relationship between retinal sensitivity and macular thickness in the DM1 group. [ABSTRACT FROM AUTHOR]

Background: A majority of multiple sclerosis patients experience visual impairment, often as the initial presenting symptom of the disease. While structural changes in the retinal nerve fiber layer and optic nerve have demonstrated correlations with brain atrophy in multiple sclerosis using magnetic resonance imaging, a non-invasive, cost-effective, and clinically efficacious modality to identify early damage and facilitate prompt therapeutic intervention to slow the progression of multiple sclerosis and its ocular manifestations, is still urgently needed. In this study, we sought to determine the role of macular sensitivity measured by microperimetry in the detection of subclinical multiple sclerosis-related retinal damage and visual dysfunction.Methods: This cross-sectional observational case-control study involved population-based samples of multiple sclerosis patients and age-, race-, and gender-matched healthy control subjects. Among the key criteria for the multiple sclerosis patients were diagnosis by the McDonald criteria, visual acuity greater than 20/25, and no history of optic neuritis. Macular sensitivity and average macular thickness were measured in all subjects using microperimetry and spectral-domain optical coherence tomography, respectively. Pearson correlation coefficients were measured using bivariate correlations. Sample means, mean differences, and 95% confidence intervals were calculated using independent sample t-tests.Results: Twenty-eight eyes from 14 MS patients and 18 eyes from 9 control subjects were included. Mean macular sensitivity of control subjects and multiple sclerosis patients in decibels was 18.2 ± 0.4 and 16.5 ± 0.4, respectively, corresponding to a mean difference of 1.7 (95% CI, 1.1-2.4; P < 0.001). Macular sensitivity was positively correlated with macular thickness in multiple sclerosis patients (r = 0.49, P = 0.01) but not control subjects (r = 0.15, P = 0.55).Conclusions: Macular sensitivity as measured by microperimetry was decreased in multiple sclerosis patients with normal visual acuity and no history of optic neuritis. Furthermore, macular sensitivity demonstrated a positive correlation with macular thickness as measured by optical coherence tomography. As such, microperimetry may represent a non-invasive and efficient method to identify signs of subclinical visual dysfunction that correspond with early macular architectural changes characteristic of multiple sclerosis. [ABSTRACT FROM AUTHOR]