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Charlotte W. T. A. Lardenoye, Kiki Probst, Peter Jaap DeLint, Aniki Rothova; Photoreceptor Function in Eyes with Macular Edema. Invest. Ophthalmol. Vis. Sci. 2000;41(12):4048-4053.
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purpose. The irreversible loss of visual acuity in macular edema is usually
attributed to permanent loss of photoreceptor cells, although there is
hardly any information on changes in photoreceptor function in macular
edema. The purpose of this study was to assess photoreceptor function
in various stages of macular edema and to relate the findings to visual
acuity and angiographic changes.
methods. Directional sensitivity (optical Stiles–Crawford effect) and visual
pigment density of foveal cones was measured with a custom-built
scanning laser ophthalmoscope (SLO) in 19 eyes of 19 patients. Twelve
eyes exhibited macular edema: five of inflammatory origin, and seven of
diabetic origin. Seven eyes with an intraocular inflammatory disease
without clinical or angiographic evidence of edema were also included
(four of which had previous macular edema and one of which had shown
development of macular edema at the 1-year follow-up). Results of SLO
measurements were related to findings using fluorescein angiography and
Snellen visual acuity, both assessed at the time of SLO measurement and
6 months thereafter.
results. Eyes with macular edema exhibited diminished directional sensitivity of
photoreceptor cells in the fovea compared with eyes without
(P = 0.02). Visual pigment density of eyes with
macular edema was decreased and associated with both initial and
follow-up visual function and with the angiographic macular edema grade
at follow-up. Abnormal directional sensitivity and pigment density were
already present in eyes with slight edematous changes and normal visual
conclusions. Eyes with inflammatory or diabetic macular edema showed decreased
directional sensitivity and visual pigment density in the macular area.
These findings may support a role for SLO measurements in detecting
retinal damage due to macular edema.
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