Analysis of Functional Dissociations between Best Corrected Visual Acuity and Microperimetric Parameters in Neovascular Age-Related Macular Degeneration Patients Underwent to Three Monthly Ranibizumab Injections
|Stefano Lazzeri1,2*, Paolo Piaggi3,4, Maria Cristina Parravano2, Guido Ripandelli2, Maria Sole Sartini1, Fabio Scarinci2, Gaetano Cupo2, Gianluca Guidi1, Andrea Cacciamani1, Marco Nardi1, Piergiorgio Neri5, Monica Varano2 and Michele Figus1|
|1Department of Neuroscience, Ophthalmology, University of Pisa, Pisa, Italy|
|2Bietti Foundation, IRCCS, Rome, Italy|
|3Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy|
|4Department of Energy and Systems Engineering, University of Pisa, Pisa, Italy|
|5Head of Ocular Immunology Unit, Ophthalmology, University of Ancona, Ancona, Italy|
|Corresponding Author :||Stefano Lazzeri, MD
Department of Neuroscience
Ophthalmology, University of Pisa
Via Paradisa 2, Pisa 56100, Italy
Tel: +39 050997634
E-mail: [email protected]
|Received July 25, 2013; Accepted August 29, 2013; Published August 31, 2013|
|Citation: Lazzeri S, Piaggi P, Parravano MC, Ripandelli G, Sartini MS, et al. (2013) Analysis of Functional Dissociations between Best Corrected Visual Acuity and Microperimetric Parameters in Neovascular Age-Related Macular Degeneration Patients Underwent to Three Monthly Ranibizumab Injections. J Clin Exp Ophthalmol 4:293. doi:10.4172/2155-9570.1000293|
|Copyright: © 2013 Lazzeri S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: To analyze the sensitivity of best corrected visual acuity and microperimetry to detect significant visual changes after 3 intravitreal ranibizumab in exudative age-related macular degeneration.
Design: Prospective, open-label study.
Participants: 50 eyes of 50 naïve patients affected by neovascular age-related macular degeneration were enrolled.
Methods: Enrolled patients underwent to a loading phase of 3 monthly intravitreal injections of ranibizumab. Best-corrected visual acuity was investigated with the ETDRS chart at 4 m. Central retinal sensitivity was tested with microperimetry using a Goldmann III stimulus to 33 points over the 12° central of the macula with a 4-2 double staircase strategy.
Main outcome measures: Comparison of changes in mean 4° central retinal sensitivity and best-corrected visual acuity in “BCVA relatively stable patients” (defined as change ≤ ± 4 ETDRS letters after treatment). Analysis of a possible relationship between changes in best-corrected visual acuity and 4° central retinal sensitivity in “mean 4° central retinal sensitivity relatively stable patients” (defined as change in mean retinal sensitivity ≤ ± 2dB)
Results: Mean best-corrected visual acuity improved of 5.90 ± 11.29 ETDRS letters (P=0.0006). Total mean retinal sensitivity improved +1.59 ± 2.12 dB (P<0.0001), while in the 4° central retinal area the increase was +1.36 ± 3.45 dB (P=0.0078). 38% of patients (19 eyes) were considered as “BCVA relatively stable patients”. In this subgroup, Pearson’s correlation analysis showed a direct correlation between changes observed with both methods (r = 0.71; P = 0.002). 48% of patients (24 eyes) were considered as “Mean 4° central retinal sensitivity relatively stable patients”. In this subgroup, Pearson’s correlation analysis didn’t show a relationship between changes observed with both methods (r = 0.11; P = 0.56).
Conclusions: Microperimetry central retinal sensitivity seems to be an important to complete the functional evaluation in patients with wet age-related macular degeneration after 3 intravitreal ranibizumab.