BACKGROUND: Different tests were applied to test the sensitivity of patient self-control; Amsler grid and visual acuity (VA) assessment, as well as fundus examinations to reveal recurrent choroidal neovascularisation (CNV) activity in age-related macular degeneration as detected by spectral domain optical coherence tomography (SD-OCT) in monthly controls. METHODS: A prospective interventional case series of patients with exudative age-related macular degeneration was examined, which received ranibizumab injections until complete resolution of fluid in SD-OCT. Analysis of changes in subjective perception, Amsler grid, early treatment diabetic retinopathy study (ETDRS) VA, Radner reading VA and fundus examination was conducted in the case of OCT-confirmed CNV recurrences. RESULTS: Out of 40 morphological recurrences determined by SD-OCT, six (15%) were noticed by subjective patient perception. Amsler grid testing revealed deterioration in 12 cases (30%); 11 recurrences (28%) were accompanied by loss of ≥5 letters in ETDRS VA and/or ≥ 1 line in Radner VA; fundus examination showed signs of novel CNV activity in 10 out of 40 recurrences (25%). The combined sensitivity of all diagnostic methods compared to SD-OCT for recurrence detection was 67.5% (27 out of 40 recurrences). CONCLUSION: Subjective patient perception, Amsler grid, VA as well as fundus examination lead to pronounced underestimations of CNV recurrences. Morphologic recurrences can be detected prior to functional deterioration. As any delay of treatment can result in irreversible vision loss, attempts should be made to provide monthly OCT controls to detect recurrences as early as possible.
BACKGROUND: Different tests were applied to test the sensitivity of patient self-control; Amsler grid and visual acuity (VA) assessment, as well as fundus examinations to reveal recurrent choroidal neovascularisation (CNV) activity in age-related macular degeneration as detected by spectral domain optical coherence tomography (SD-OCT) in monthly controls. METHODS: A prospective interventional case series of patients with exudative age-related macular degeneration was examined, which received ranibizumab injections until complete resolution of fluid in SD-OCT. Analysis of changes in subjective perception, Amsler grid, early treatment diabetic retinopathy study (ETDRS) VA, Radner reading VA and fundus examination was conducted in the case of OCT-confirmed CNV recurrences. RESULTS: Out of 40 morphological recurrences determined by SD-OCT, six (15%) were noticed by subjective patient perception. Amsler grid testing revealed deterioration in 12 cases (30%); 11 recurrences (28%) were accompanied by loss of ≥5 letters in ETDRS VA and/or ≥ 1 line in Radner VA; fundus examination showed signs of novel CNV activity in 10 out of 40 recurrences (25%). The combined sensitivity of all diagnostic methods compared to SD-OCT for recurrence detection was 67.5% (27 out of 40 recurrences). CONCLUSION: Subjective patient perception, Amsler grid, VA as well as fundus examination lead to pronounced underestimations of CNV recurrences. Morphologic recurrences can be detected prior to functional deterioration. As any delay of treatment can result in irreversible vision loss, attempts should be made to provide monthly OCT controls to detect recurrences as early as possible.
Authors: Haiyan Wang; Giulio Barteselli; William R Freeman; Su Na Lee; Jay Chhablani; Sharif El-Emam; Lingyun Cheng Journal: Int J Ophthalmol Date: 2013-10-18 Impact factor: 1.779
Authors: Claus von der Burchard; Helge Sudkamp; Jan Tode; Cristoph Ehlken; Konstantine Purtskhvanidze; Moritz Moltmann; Britta Heimes; Peter Koch; Michael Münst; Malte Vom Endt; Timo Kepp; Dirk Theisen-Kunde; Inke König; Gereon Hüttmann; Johann Roider Journal: BMJ Open Date: 2022-06-27 Impact factor: 3.006
Authors: Florence Coscas; Marco Lupidi; Jean François Boulet; Alexandre Sellam; Diogo Cabral; Rita Serra; Catherine Français; Eric H Souied; Gabriel Coscas Journal: Br J Ophthalmol Date: 2018-11-22 Impact factor: 4.638