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Diagnostik von Metamorphopsien bei Netzhauterkrankungen unterschiedlicher Genese

Diagnostics of metamorphopsia in retinal diseases of different origins

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Zusammenfassung

Wir untersuchten die Detektionsraten des Preferential-Hyperacuity-Perimeter- (PHP) sowie des Amsler-Tests für Metamorphopsien bei Patienten mit Makulaforamen (MF), Retinopathia centralis serosa (RCS), epiretinalen Membranen (EM), intermediärer altersbedingter Makuladegeneration (iAMD) sowie klassischen und okkulten choroidalen Neovaskularisationen (CNV) und verglichen die Ergebnisse. Wir untersuchten 147 Patienten (n=153 Augen) mit klassischer (35 Augen) und okkulter (38 Augen) CNV, iAMD (13 Augen), MF (23 Augen), RCS (11 Augen) sowie EM (13 Augen); Kontrollgruppe: 20 Augen. Bei allen Patienten wurde ein bestkorrigierter Fernvisus erhoben sowie ein Amsler-Test durchgeführt. Der PHP-Test erfolgte nach Pupillenerweiterung durch einen Untersucher. Bei allen Patienten wurde eine Fundusfotografie sowie OCT-Untersuchung (Humphrey/Zeiss OCT III) durchgeführt. Bei Patienten mit CNV und RCS erfolgte darüber hinaus eine Fluoreszeinangiographie. Die Detektionsraten für Metamorphopsien von PHP- und Amsler-Test wurden verglichen und statistisch ausgewertet. Die Sensitivität des PHP- im Vergleich zum Amsler-Test zur Detektion von Metamorphopsien betrug bei Patienten mit MF 69% vs. 85%, bei RCS 64% vs. 73%, bei EM 77% vs. 100%, bei iAMD 85% vs. 100%, bei klassischer CNV 83% vs. 94% und bei okkulter CNV 81% vs. 71%. Die Ergebnisse für Patienten mit okkulter CNV waren statistisch signifikant unterschiedlich (p=0,046, Chi-Quadrat-Test), alle anderen Ergebnisse waren ohne statistisch signifikanten Unterschied. Lediglich bei okkulten CNV ist die Detektionsrate und die Sensitivität des PHP-Tests dem Amsler-Test leicht überlegen. Bei allen anderen untersuchten Makulaerkrankungen zeigte sich eine höhere Sensitivität des Amsler-Tests gegenüber der PHP-Untersuchung (statistisch nicht signifikant bei niedrigen Fallzahlen).

Abstract

We investigated the ability of preferential hyperacuity perimeter (PHP) and Amsler grid testing to detect metamorphosia in patients with macular hole (MH), central serous retinopathy (CSR), epiretinal membranes (EM), intermediate AMD (iAMD), classic and occult choroidal neovascularization (CNV) due to AMD, and compared the results. A total of 147 patients (n =153 eyes) with classic (35 eyes) and occult (38 eyes) CNV, iAMD (13 eyes), MF (23 eyes), RCS (11 eyes), EM (13 eyes) and control group (20 eyes) were involved. All of these patients underwent corrected visual acuity and eye examinations inclusive of the Amsler grid. The PHP test was performed after pupil dilation. In all patients, fundus photography and optical coherence tomography (OCT) (Humphrey/Zeiss OCT III) were performed. In patients with CNV and CSR a fluorescein angiography was also performed. Metamorphopsia detection rates by Amsler grid and PHP were compared statistically. The sensitivity of PHP vs Amsler grid in detecting metamorphosia was 69% vs 85% in patients with MH, for CSR 64% vs 73%, EM 77% vs 100%, iAMD 85% vs 100%, classic CNV 83% vs 94% and occult CNV 81% vs 71%. The results for patients with occult CNV were significant (P =0.046), using the χ2-test. The PHP-test showed high sensitivity for diagnosing CNV. In occult CNV, PHP was superior to the Amsler grid in detecting metamorphopsia. In the other diseases involving the macular (MH, EM, CSR, iAMD), the detection rate and sensitivity of the Amsler grid was superior to PHP.

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Authors and Affiliations

  1. Augenklinik des Universitätsklinikums Schleswig-Holstein, Campus Kiel, Hegewischstraße 2, 24105 , Kiel

    C. Klatt, L. Ponomareva, A. Bunse & J. Roider

  2. Klinik und Poliklinik für Augenheilkunde der Universität Regensburg

    P. Sendtner, J. Hillenkamp & V.-P. Gabel

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  1. C. Klatt
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  2. P. Sendtner
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  3. L. Ponomareva
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  4. J. Hillenkamp
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  5. A. Bunse
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  6. V.-P. Gabel
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  7. J. Roider
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Correspondence to C. Klatt.

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Klatt, C., Sendtner, P., Ponomareva, L. et al. Diagnostik von Metamorphopsien bei Netzhauterkrankungen unterschiedlicher Genese. Ophthalmologe 103, 945–952 (2006). https://doi.org/10.1007/s00347-006-1381-0

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  • DOI: https://doi.org/10.1007/s00347-006-1381-0

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