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Microperimetry as a routine diagnostic test in the follow-up of retinal vein occlusion?

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

In the follow-up of retinal vein occlusions, a patient’s subjective change in vision frequently cannot be confirmed by objective measurements. Furthermore, contradictory results of OCT and distance visual acuity give the impression that current routine diagnostic tests might not be satisfying for patients with retinal vein occlusions. This prospective case series analyses the value of microperimetry as a routine diagnostic test in the follow-up of patients with retinal vein occlusions during therapy.

Methods

In a prospective case series, we tested microperimetry as a functional measure in comparison to distance visual acuity, reading ability, and OCT, on 13 patients treated for central or branch retinal vein occlusions. Treatment consisted of intravitreal bevacizumab injections combined with panretinal laser coagulation in cases of peripheral ischemia. If macular edema persisted, bevacizumab injection was repeated, or instead of this intravitreal triamcinolone or focal laser coagulation was applicated. Follow-up ranged from 6–14 months. An interim analysis was performed for the 6-month follow-up.

Results

In the branch retinal vein occlusion group, the average of the retinal thickness measured by OCT was 502.22 μm (±SD 217.75 μm) at baseline and changed to 396.38 ± 154.38 at the 6-month follow-up (p = 0.121). Mean distance visual acuity stayed similar to the study entrance with 0.41 ± 0.34 at the 6-month follow-up (p = 0.944) Mean reading ability improved to 0.51 ± 0.52 at the 6-month follow-up but was not statistically significant (p = 0.435). The mean light sensitivity of microperimetry improved from baseline to the 6-month follow-up: the 40-points group improved from 8.62 ± 5.69 dB to 10.98 ± 5.42 (p = 0.060) and the 8-points group from 6.27 dB to 9.6 dB (p = 0.07) but missed statistical significance. The sector group showed in contrast to this an improvement from 6.02 ± 5.71 dB to 9 ± 6.07 dB (p = 0.025), which was statistically significant. Changes in the central vein occlusion group were not statistically significant but changes for both groups together showed statistical significance.

Conclusions

In the present case series, microperimetry was more convenient to detect, even the subtle functional changes during the disease course of branch retinal vein occlusions than distance and reading visual acuity. This indicates that microperimetry could be a possible valuable tool in the follow-up of branch retinal vein occlusions.

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References

  1. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S (2006) ANCHOR study group: ranibizumab vs. verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444

    Article  PubMed  CAS  Google Scholar 

  2. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY (2006) Ranibizumab for age-related macular generation. MARINA study. N Engl J Med 355:1419–1431

    Article  PubMed  CAS  Google Scholar 

  3. Massin P, Bandello F, Garweg JG, Hanssen LL, Harding SP, Larsen M, Mitchell P, Scharp D, Wolf Schnurrbusch UE, Gekkieva M, Weichselberger A, Wolf S (2010) Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes Care 33(11):2399–2405

    Article  PubMed  CAS  Google Scholar 

  4. Nicholson BP, Schachat AP (2010) A review of clinical trials of anti-VEGF agents for diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 248(7):915–930

    Article  PubMed  CAS  Google Scholar 

  5. Kampik A, Priglinger S (2008) Intravitreal bevacizumab for the treatment of macular oedema secondary to branch vein occlusion. Br J Ophthalmol 92:351–355

    Article  PubMed  Google Scholar 

  6. Jaissle GB, Leitritz M, Gelisken F (2009) One-year results after intravitreal bevacizumab therapy for macular oedema secondary to branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 247:27–33

    Article  PubMed  CAS  Google Scholar 

  7. Kiss CG, Barisani-Asenbauer T, Simader C, Maca S, Schmidt-Erfurth U (2008) Central visual field impairment during and following cystoid macular oedema. Br J Ophthalmol 92:84–88

    Article  PubMed  CAS  Google Scholar 

  8. Rohrschneider K, Bueltmann S, Springer C (2008) Use of fundus perimetry (microperimetry) to quantify macular sensitivity. Prog Retinal Eye Res 27:536–548

    Article  Google Scholar 

  9. Ferris FL, Kassoff A, Bresnick GH, Bailey I (1982) New visual acuity charts for clinical research. Am J Ophthalmol 94:91–96

    PubMed  Google Scholar 

  10. Radner W, Willinger U, Obermayer W (1998) Eine neue Lesetafel zur gleichzeitigen Bestimmung von Lesevisus und Lesegeschwindigkeit. Klin Monatsbl Augenheilkd 213:174–181

    Article  PubMed  CAS  Google Scholar 

  11. Stifter E, Konig F, Lang T, Bauer P, Richter-Müksch S, Velikay-Parel M, Radner W (2004) Reliability of a standardized reading chart system: variance component analysis, test-retest and inter-chart reliability. Graefes Arch Clin Exp Ophthalmol 242:31–39

    Article  PubMed  Google Scholar 

  12. Morwood SL (2000) Research strategies for advanced practice nurses. Prentice Hall Health, New Jersey

    Google Scholar 

  13. du Prel JB, Hommel G, Röhrig B, Blettner M (2009) Confidence interval or p-value?: part 4 of a series on evaluation of scientific publications. Dtsch Arztebl Int 106(19):335–339

    PubMed  Google Scholar 

  14. Ach T, Hoch A, Schaal K, Scheuerle AF, Dithmar S (2009) Predictive factors for changes in macular edema in intravitreal bevacizumab therapy for retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. doi:10.1007/s00417-009-1167-6

  15. Kriechbaum K, Prager F, Geitzenauer W, Benesch T, Schütze C, Simader C, Schmidt-Erfurth U (2009) Association of retinal sensitivity and morphology during antiangiogenic treatment of retinal vein occlusion over one year. Opthalmology 116:2415–2421

    Article  Google Scholar 

  16. Senturk F, Ozdemir H, Karacorlu M, Karacorlu S, Uysal O (2010) Mircoperimetric changes after intravitreal triamcinolone acetonide injection for macular edema due to central retinal vein occlusion. Retina 30:1254–1261

    Article  PubMed  Google Scholar 

  17. Midena E, St V, Convento E, Manfré A, Cavarzeran F, Pilotto E (2007) Microperimetry and fundus autofluorescence in patients with early age- related macular degeneration. Br J Ophthalmol 91:1499–1503

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, University of Berlin, Charité Virchowklinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Sibylle Winterhalter, Anna Karina Maier, Florian M. A. Heußen & Antonia M. Joussen

  2. Department of Ophthalmology, University of Duesseldorf, Duesseldorf, Germany

    Anja Lux & Klaudia K. Huber

  3. Department of Cardiology, Helios Hospital Wuppertal, Wuppertal, Germany

    Clara Scholz

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  1. Sibylle Winterhalter
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  2. Anja Lux
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  3. Anna Karina Maier
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  4. Clara Scholz
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  5. Florian M. A. Heußen
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  6. Klaudia K. Huber
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  7. Antonia M. Joussen
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Correspondence to Sibylle Winterhalter.

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Winterhalter, S., Lux, A., Maier, A.K. et al. Microperimetry as a routine diagnostic test in the follow-up of retinal vein occlusion?. Graefes Arch Clin Exp Ophthalmol 250, 175–183 (2012). https://doi.org/10.1007/s00417-011-1784-8

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  • DOI: https://doi.org/10.1007/s00417-011-1784-8

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