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O. R. Ahmad, R. P. Singh; The Effect of Macular Edema on Macular Function as Measured by Microperimetry in Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):84.
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The purpose of this study is to see if macular edema in the setting of exudative age-related macular degeneration reduces macular function as measured by microperimetry.
11 eyes of ten patients with history of exudative macular degeneration underwent microperimetry testing and SD-OCT imaging using the OPKO Spectral OCT SLOtm device. Microperimetry testing consisted of a Goldmann III size stimulus with projection time of 200 ms, with a polar 3-12 degree pattern and a 4-2 double staircase strategy. The following data was recorded: presence of central macular edema, retinal thickness (microns) at the four central microperimetry points one degree from fixation, macular sensitivity (dB) at the central four points one degree from fixation measured from 0 to 20.
4 of 11 eyes (36%) had central macular edema as evidenced by OCT, with an average retinal thickness at the four central points in these eyes 325.2 ± 110.5 microns. The average retinal thickness of the 7 eyes without macular edema measured 259.4 ± 47.2 microns. The retinal sensitivity of those points that had macular edema measured 8.25 ± 2.7 dB, while the retinal sensitivity of those without macular edema measured 7.64 ± 4.0 dB. Retinal sensitivity was poorly correlated with retinal thickness (r2=0.0148). Only 5 of the 11 microperimetry studies were able to be completed.
The presence of macular edema did not lead to a significantly lower level of retinal sensitivity. In addition, retinal thickness did not correlate with retinal sensitivity in this study. Several reasons for these findings are possible, including 1) areas of scar and atrophy being a greater determinate of ultimate retinal sensitivity 2) a significant portion of patients fixating eccentrically 3) a large percentage of patients being unable to complete the microperimetry study. Further studies should be carried out to determine the utility of microperimetry in the setting of exudative age-related macular degeneration.
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