Abstract
Purpose:
Age related macular degeneration (AMD) and idiopathic macular hole (IMH) are diseases affecting the macula that lead to abnormalities in central vision (acuity, scotoma, metamorphopsia, micropsia, macropsia). D Charts are a newly developed method of microperimetry that measures and monitors metamorphopsia strength in the macular region, contributing to the diagnosis and management of patients with macular diseases.<br /> <br /> Our purpose is to test the ability of D-charts microperimetry to map the visual defects in patients with advanced AMD (before and after application of anti-VEGF drugs) and in patients with IMH (before and after surgical treatment).
Methods:
Retrospective study ofn 2 groups of patients - with AMD and with IMH, was performed. All patients underwent complete eye examination and optical coherence tomography (OCT). In patients with AMD, fluorescein angiography (FA) was also performed. Patients with AMD received 3 intravitreal injections with anti-VEGF drug (Aflibercept) in 1 month intervals. Patients with IMH underwent surgery - PPV with gas SF6 20%. D-charts microperimetry was conducted before and 2 months after the last anti-VEGF application in patients with AMD. In patients with IMH, D charts microperimetry was performed before surgery and 1 month after full resorption of the gas tamponade.
Results:
Ten patients were included in this retrospective study. Nine patients (4 with AMD and 5 with IMH) showed improvement in the D Charts test results after treatment. In one patients (with AMD), central vision and visual field defects remained stable but he reported subjective vision improvement. D-charts microperimetry test demonstrated good correlation between the functional disorders and structural changes in the macula documented with OCT.
Conclusions:
D-charts microperimetry is a non-invasive, subjective and repeatable method, for detection of subtle changes in central vision in patients with macular pathology. This study confirms the hypothesis that D charts make possible monitoring of patients with low vision and unstable fixation who cannot be examined with standard perimetry. D-charts microperimetry is a useful method to trace the natural progression of macular diseases, as well as for treatment monitoring. It is indispensable when microperimetry equipment (MAYA) is not available.