Skip to main content
SpringerLink
Log in

Assessment of visual function in choroidal neovascularization with scanning laser microperimetry and simultaneous indocyanine green angiography

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

Abstract

• Background: Clinical management and treatment of diseases with choroidal neovascularization (CNV) are mainly based on visual acuity, which may give an incomplete picture of the associated visual dysfunctions. With the advent of new experimental treatment modalities such as alfa-interferon, radiation, or surgical excision of CNV, it is increasingly important to develop better methods for characterizing the associated visual function. Microperimetry with the scanning laser ophthalmoscope (SLO) allows precise point-to-point correlation between visual function and the macular pathology. However, precise delineation of CNV is a prerequisite for accurate correlation of the functional results with the CNV. • Methods: A total of 40 eyes with CNV secondary to age-related macular degeneration were evaluated with static manual microperimetry using the SLO to quantitate relative and absolute scotomata within the CNV. For precise delineation of the CNV, indocyanine green (ICG) angiography was simultaneously performed, allowing stimulus presentation at any desired retinal location under visual feedback of the angiogram. • Results: A relative scotoma was detected in 19 and an absolute scotoma in 21 out of 40 eyes. The depth of the scotomata was correlated with the duration of symptoms (P<0.01). Eyes with well-defined CNV had significantly deeper scotomas than eyes with occult CNV (P<0.005). • Conclusion: Microperimetry using the SLO and simultaneous ICG angiography demonstrated relative and absolute scotoma within the CNV. The depth of the scotoma may guide the ophthalmologist in selecting the adequate treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Acosta F, Lashkari K, Reynaud X, Jalkh AE, Van de Velde F, Chedid N (1991) Characterization of functional changes in macular holes and cysts. Ophthalmology 98:1820–1823

    Google Scholar 

  2. Berger AS, Kaplan HJ (1992) Clinical experience with the surgical removal of subfoveal neovascular membranes. Short-term postoperative results. Ophthalmology 99:969–976

    Google Scholar 

  3. Bressler SB, Bressler NM, Fine SL, Hillis A, Murphy RP, Olk RJ, Patz A (1982) Natural course of choroidal neovascular membranes within the foveal avascular zone in senile macular degeneration. Am J Ophthalmol 93:157–163

    Google Scholar 

  4. Bressler NM, Bressler SB, Fine SL (1988) Age-related macular degeneration. Surv Ophthalmol 32:375–413

    Google Scholar 

  5. Chakravarthy U, Houston RF, Archer DB (1993) Treatment of age-related subfoveal neovascular membranes by teletherapy: a pilot study. Br J Ophthalmol 77:265–273

    Google Scholar 

  6. Chan CK, Kempin SJ, Noble SK, Palmer GA (1994) The treatment of choroidal neovascular membranes by alpha interferon. An efficacy and toxicity study. Ophthalmology 101:289–300

    Google Scholar 

  7. Cherrick GR, Stein SW, Levy CM (1960) Indocyanine green: observations on its physical properties, plasma decay and hepatic extraction. J Clin Invest 539:592

    Google Scholar 

  8. Chylack LT, Leske MC, McCarthy D, Khu P, Kashiwagi T, Sperduto R (1989) Lens opacities classification system II (LOGS 1I). Arch Ophthalmol 107:991–997

    Google Scholar 

  9. Delori FC, Gragoudas ES, Fransico R, Pruett RC (1977) Monochromatic ophthalmoscopy and fundus photography: the normal fundus. Arch Ophthalmol 95:861–868

    Google Scholar 

  10. Ferris FL, Fine SL, Hyman L (1984) Age-related macular degeneration and blindness due to neovascular maculopathy. Arch Ophthalmol 102:1640–1642

    Google Scholar 

  11. Fletcher DC, Sabates FN (1992) Surgical excision of subfoveal neovascular membranes in age-related macular degeneration. Am J Ophthalmol 114:241–242

    Google Scholar 

  12. Freund KB, Yannuzzi LA, Sorenson JA (1993) Age-related macular degeneration and choroidal neovascularization. Am J Ophthalmol 115:786–791

    Google Scholar 

  13. Fung WE (1991) Interferon alpha 2a for treatment of age-related macular degeneration. (letter) Am J Ophthalmol 112:349–350

    Google Scholar 

  14. Guyer DR, Fine SL, Maguire MG, Hawkins BS, Owns SL, Murphy RP (1986) Subfoveal choroidal neovascular membranes in age-related macular degeneration. Visual prognosis in eyes with relatively good visual acuity. Arch Ophthalmol 104:702–705

    Google Scholar 

  15. Kuck H, Inhoffen W, Schneider U, Kreissig I (1993) Diagnosis of occult subretinal neovascularization in age-related macular degeneration by infrared scanning laser videoangiography. Retina 13:36–39

    Google Scholar 

  16. Lambert HM, Capone A, Aaberg TM, Sternberg P, Mandell B, Lopez PF (1992) Surgical excision of subfoveal neovascular membranes in age-related macular degeneration. Am J Ophthalmol 1113:257–262

    Google Scholar 

  17. Leibowitz H, Krueger DE, Maunder LR (1980) The Framingham Eye Study monograph: an ophthalmological and epidemiologic study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults 1973–1975. Surv Ophthalmol [Suppl] 24:335–610

    Google Scholar 

  18. Macular Photocoagulation Study Group (1990) Krypton laser photocoagulation for neovascular lesions of age-related macular degeneration: results of a randomized clinical trial. Arch Ophthalmol 108:816–824

    Google Scholar 

  19. Macular Photocoagulation Study Group (1991) Argon laser photocoagulation for neovascular maculopathy: five year results from randomized clinical trials. Arch Ophthalmol 109:1109–1114

    Google Scholar 

  20. Macular Photocoagulation Study Group (1993) Laser photocoagulation of subfoveal neovascularlesions of age-related macular degeneration. Updated findings from two clinical trials. Arch Ophthalmol 111:1200–1209

    Google Scholar 

  21. Macular Photocoagulation Study Group (1994) Visual outcome after laser photocoagulation for subfoveal neovascular lesions secondary to age-reated macular degeneration. The influence of initial lesion size and initial visual acuity. Arch Ophthalmol 112:480–488

    Google Scholar 

  22. Macular Photo coagulation Study Group (1994) Laser photocoagulation forjuxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Arch Ophthalmol 112:500–509

    Google Scholar 

  23. Regillo CD, Benson WE, Maguire JI, Annesley WH (1994) Indocyanine green angiography and occult choroidal neovascularization. Ophthalmology 101:280–288

    Google Scholar 

  24. Russell SR, Crapotta JA, Zerolio DJ (1993) Surgical removal of subfoveal neovascularization. (letter) Ophthalmology 100:795–796

    Google Scholar 

  25. Scheider A, Kaboth A, Neuhauser L (1992) Detection of subretinal membranes with indocyanine green and an infrared scanning laser ophthalmoscope. Am J Ophthalmol 113:45–51

    Google Scholar 

  26. Slakter JS, Yannuzzi LA, Sorenson JA, Guyer DR, Orlock DA (1994) A pilot study of indocyanine green videoangiography-guided laser photocoagulation of occult choroidal neovascularization in age-related macular degeneration. Arch Ophthalmol 112:462–475

    Google Scholar 

  27. Stürmer J, Schrödel C, Rappl W (1990) Scanning laser ophthalmoscope for static fundus-controlled perimetry. In: Nasemann JE, Burk ROW (eds) Scanning laser ophthalmoscopy and tomography. Quintessenz, Munich, pp 133–146

    Google Scholar 

  28. Thomas MA, Ibanez HE (1993) Interferon alfa-2a in the treatment of subfoveal neovascularization. Am J Opthalmol 115:563–568

    Google Scholar 

  29. Thomas MA, Grand MG, Williams DF, Lee CM, Pesin SR, Lowe MA (1992) Surgical management of subfoveal choroidal neovascularization. Ophthalmology 99:952–968

    Google Scholar 

  30. Timberlake GT, Van de Velde FJ, Jalkh AE (1989) Clinical use of scanning laser ophthalmoscopy retinal function maps in macular disease. Lasers Light Ophthalmol 2:211–222

    Google Scholar 

  31. Wolf S, Wald JW, Elsner AE, et al. (1993) Indocyanine green choroidal videoangiography: a comparison of imaging analysis with the scanning laser ophthalmoscope and the fundus camera. (letter) Retina 13:266–269

    Google Scholar 

  32. Yannuzzi LA, Slakter JS, Sorenson JA, Guyer DR, Orlock DA (1992) Digital indocyanine green videoangiography and choroidal neovascularization. Retina 12:191–223

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology Ill, University Eye Clinic, Schleichstrasse 12, D-72076, Tübingen, Germany

    Ulrike Schneider, Werner Inhoffen, Faik Gelisken & Ingrid Kreissig

Authors
  1. Ulrike Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Werner Inhoffen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Faik Gelisken
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ingrid Kreissig
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Presented in part at Macula: New Frontier, An International Symposium, Kansas City, Missouri, 1994

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schneider, U., Inhoffen, W., Gelisken, F. et al. Assessment of visual function in choroidal neovascularization with scanning laser microperimetry and simultaneous indocyanine green angiography. Graefe's Arch Clin Exp Ophthalmol 234, 612–617 (1996). https://doi.org/10.1007/BF00185293

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00185293

Keywords

Search

Navigation