PURPOSE: To evaluate the retinal functional changes measured by scanning laser ophthalmoscope microperimetry in neovascular age-related macular degeneration treated with ranibizumab injections. DESIGN: Prospective, interventional case series. METHODS: A total of 42 eyes of 39 patients with neovascular age-related macular degeneration were included. After an initial 3 loading injections of ranibizumab, 0.5 mg per injection per month, injection was performed as needed. Evaluation of best-corrected visual acuity, microperimetry, and optical coherence tomography were performed before treatment and 3 months, 6 months, and 12 months after treatment. According to the appearance of the subfoveal choroidal neovascular membrane on fluorescein angiography, the study group was divided into patients with a predominantly or purely classic choroidal neovascular membrane, those with a minimally classic choroidal neovascular membrane, and patients with occult choroidal neovascular membrane. RESULTS: In all the subjects, mean retinal sensitivity of the central 12-degree area had increased significantly from 4.89 ± 3.1 dB to 9.82 ± 2.1 dB at month 12 (P = .01). The number of absolute scotoma points decreased significantly from 11.3 ± 3.2 to 5.9 ± 2.4 at month 12 (P = .01). However, in the subgroup analysis, the mean retinal sensitivity improvement, decreased absolute scotoma size, best-corrected visual acuity improvement, and central macular thickness improvement did not differ significantly among the groups. CONCLUSIONS: Intravitreal 0.5 mg ranibizumab therapy improves retinal function, quantified not only by visual acuity, but also by mean retinal sensitivity and fixation stability, as assessed by scanning laser ophthalmoscope microperimetry. Measurement of retinal sensitivity may facilitate evaluation of the effectiveness of intravitreal ranibizumab treatment in patients with neovascular age-related macular degeneration.
PURPOSE: To evaluate the retinal functional changes measured by scanning laser ophthalmoscope microperimetry in neovascular age-related macular degeneration treated with ranibizumab injections. DESIGN: Prospective, interventional case series. METHODS: A total of 42 eyes of 39 patients with neovascular age-related macular degeneration were included. After an initial 3 loading injections of ranibizumab, 0.5 mg per injection per month, injection was performed as needed. Evaluation of best-corrected visual acuity, microperimetry, and optical coherence tomography were performed before treatment and 3 months, 6 months, and 12 months after treatment. According to the appearance of the subfoveal choroidal neovascular membrane on fluorescein angiography, the study group was divided into patients with a predominantly or purely classic choroidal neovascular membrane, those with a minimally classic choroidal neovascular membrane, and patients with occult choroidal neovascular membrane. RESULTS: In all the subjects, mean retinal sensitivity of the central 12-degree area had increased significantly from 4.89 ± 3.1 dB to 9.82 ± 2.1 dB at month 12 (P = .01). The number of absolute scotoma points decreased significantly from 11.3 ± 3.2 to 5.9 ± 2.4 at month 12 (P = .01). However, in the subgroup analysis, the mean retinal sensitivity improvement, decreased absolute scotoma size, best-corrected visual acuity improvement, and central macular thickness improvement did not differ significantly among the groups. CONCLUSIONS: Intravitreal 0.5 mg ranibizumab therapy improves retinal function, quantified not only by visual acuity, but also by mean retinal sensitivity and fixation stability, as assessed by scanning laser ophthalmoscope microperimetry. Measurement of retinal sensitivity may facilitate evaluation of the effectiveness of intravitreal ranibizumab treatment in patients with neovascular age-related macular degeneration.
Authors: Leon von der Emde; Maximilian Pfau; Sarah Thiele; Philipp T Möller; Ruth Hassenrik; Monika Fleckenstein; Frank G Holz; Steffen Schmitz-Valckenberg Journal: Transl Vis Sci Technol Date: 2018-01-09 Impact factor: 3.283