Artikel
Choroidal neovascularisation (CNV) during anti-VEGF therapy: Changes in microperimetric visual field defects are similar to changes in optical coherence tomography (OCT) findings in most cases
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Veröffentlicht: | 20. August 2013 |
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Gliederung
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Introduction: Using modified microperimetry (MAIA, Padua), retinal sensitivity (RS) can be measured with high density and visualized (color coded areas) in the region of CNVs. Visual fields are becoming better/worse if areas with scotoma become smaller/bigger or less/more deep. This functional development can be compared with changes in anatomic OCT findings over time (edema, neurosensory detachments (NSD)).
Methods: We examined 22 patients with CNV during anti-VEGF therapy within 6 to 14 months after first injection (control interval with both examinations: 5–8 weeks), using MAIA microperimetry (60–140 measurement pointscorresponding to CNV area, Goldman 3 and 4–2 strategy) and Spectralis OCT (Heidelberg Engineering, Dossenheim) for anatomic development (edema, cysts, NSD). The resulting 123 examinations were categorized: visual field and OCT findings better/ unchanged/ worse (separately in comparison to the findings at last examination).
Results: In 77/123 measurements both methods gave identical results (33 better, 32 unchanged, 12 worse), whereas different results were found in 46/123 measurements: better results in visual field in 32/46 (long lasting positive reaction to therapy when NSD vanished quickly), worse in 14/46 ( only very small changes over time or delayed reaction to therapy). Thus, in more than 109/123 (89%) changes in visual field and anatomic findings were correlated.
Conclusion: In most cases anatomic and functional changes during anti-VEGF therapy are correlated. Approximately 37% of visual field changes showed prolonged or delayed reaction to therapy in contrast to OCT findings.