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Changes in Retinal Layer Thickness in the?Contralateral Eye of Patients with Unilateral Neovascular Age-Related Macular Degeneration
摘要： To evaluate the thickness of the outer retinal layers and its relationship with visual function in fellow eyes of participants with unilateral neovascular age-related macular degeneration (AMD). Design: Longitudinal study. Participants: We enrolled 105 subjects with unilateral neovascular AMD from 3 clinical centers in Europe. Methods: The fellow eye, without advanced AMD, was selected for the study. Subjects were followed up with visits occurring every 6 months for 2 years. Spectral domain optical coherence tomography volume scans were collected at 3 clinical sites, in Belfast, Northern Ireland; Coimbra, Portugal; and Milan, Italy. Detailed manual segmentation of outer retinal layers was performed using the custom-designed and validated grading software 3D OCTOR. Thickness measurements for neurosensory retina, photoreceptor layer (PRL) outer segments, retinal pigment epithelium plus drusen (RPEtdrusen) complex, and choroidal layers from each sector of the standard macular grid were obtained. Measures of vison were distance visual acuity, near visual acuity, Smith-Kettlewell Institute low-luminance acuity score, and reading speed. Subjects were grouped based on the presence or absence of subretinal drusenoid deposits (SDDs) for further analysis. Main Outcome Measures: Change in thickness of retinal layers and change in measures of vision. Results: In all, 85 eyes were included in the analysis. The average duration of follow-up was 20.5 (cid:2) 5.8 months. By the ?nal visit, the RPEtdrusen complex was signi?cantly thinner when compared with baseline (29.7 mm vs. 34.09 mm; P ? 0.03). Low-luminance de?cit was signi?cantly worse at the ?nal visit (P < 0.001) and correlated with PRL outer segment thickness (r ? 0.33; P ?0.02). The RPEtdrusen complex was signi?cantly thicker in eyes with SDDs compared with that in those without SDDs (30.67 mm vs. 28.64 mm; P ? 0.02). PRL outer segments became signi?cantly thinner over time in eyes with SDDs compared with those in eyes without SDDs. Conclusions: The RPEtdrusen complex layer becomes thinner over time in fellow eyes of subjects with unilateral neovascular AMD. The rate of PRL outer segment thinning was higher in eyes with SDDs than in eyes without SDDs. These ?ndings are preliminary steps in the identi?cation of early biomarkers for detecting and monitoring the progression of AMD. Ophthalmology Retina 2018;-:1e10 a 2018 Published by Elsevier Inc. on behalf of the American Academy of Ophthalmology
关键词： spectral domain optical coherence tomography,visual function,retinal layer thickness,subretinal drusenoid deposits,age-related macular degeneration
更新于2025-09-23 15:21:01
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Microperimetry for Geographic Atrophy Secondary to Age-Related Macular Degeneration
摘要： Geographic atrophy (GA) is a progressive, advanced form of age-related macular degeneration leading to visual function impairment and irreversible vision loss. Standard clinical tests to evaluate visual function in patients with GA provide poor anatomic-functional correlation, while fundus imaging does not assess the visual function deficit. Microperimetry is a psychophysical visual function test that spatially maps retinal sensitivity and allows for correlation of anatomic features with visual function. In this review, we present an overview of mesopic microperimetry for GA, including: commercially available microperimetry devices, strategies to capture a mesopic microperimetry test, and strategies to assess and interpret microperimetry data in patients with GA. We demonstrate the importance of microperimetry data for assessing GA progression and for evaluating visual function loss through anatomic-functional correlations. Although valuable, current microperimetry tests require an extensive time commitment from patient and examiner, and the development of faster, more reproducible, and accessible methods is important to enable broader use of microperimetry in both clinical and research settings.
关键词： anatomic-functional correlation,visual function,geographic atrophy,microperimetry,age-related macular degeneration,retinal sensitivity
更新于2025-09-19 17:15:36
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Function first: classifying cell types and circuits of the retina
摘要： Cell type classification has been a major part of retina research for over one hundred years. In recent years, the ability to sample large populations of retinal cells has accelerated cell type classification based on different criteria like genetics, morphology, function, and circuitry. For example, recent work includes bipolar and retinal ganglion cell classifications based on single-cell transcriptomes, large-scale electron microscopy reconstruction, and population-level functional imaging. With comprehensive descriptions of several retinal cell classes now within reach, it is important to reflect on the priority of these different criteria to create an accurate and useful classification. Here, we argue that functional information about retinal cells should be prioritized over other criteria when addressing questions of visual function because this criterion provides the most meaningful information about how the retina works.
关键词： visual function,cell type classification,functional information,retina
更新于2025-09-10 09:29:36
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Comparison of visual performance of toric versus non-toric intraocular lenses with same material
摘要： We compared the visual performance of toric intraocular lenses (IOLs) and non-toric IOLs made of the same material. The subjects included patients implanted with either Acrysof IQ? toric IOLs (SN6AT3-9) or Acrysof IQ? IOLs (SN60WF) bilaterally. The toric group included 103 patients who were implanted with Acrysof IQ toric IOLs bilaterally. The non-toric group was a corneal astigmatism-matched control group and included 103 patients who were implanted with Acrysof IQ IOLs bilaterally. Results: The uncorrected distance visual acuity was significantly better in the toric group, whereas the uncorrected 50 cm visual acuity was better in the non-toric group. There was no significant difference in contrast sensitivity (with and without glare) between both the groups. The rate of spectacle dependency for distance vision was significantly lower in the toric group. There were no significant differences between the two groups in all items of the postoperative quality-of-vision questionnaire (25-item Visual Function Questionnaire). Conclusion: The toric IOLs used in this study reduced spectacle dependency more than the non-toric IOLs and did not compromise the subjective visual function, but the uncorrected 50 cm vision was worse in toric IOL implanted eyes.
关键词： astigmatism,cataract surgery,visual function,cataract
更新于2025-09-10 09:29:36
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Functional Visual Acuity
摘要： Dry eye (DE) causes irregularity of the ocular surface and reduces the quality of vision. An intact, regular tear ?lm is essential for high-quality retinal images; however, visual tasks requiring sustained gazing can disrupt the tear ?lm, eventually degrading visual function. A functional visual acuity (FVA) measurement system has been uniquely developed in Japan to evaluate visual function related to tear stability in patients with DE. FVA has been shown to correlate with optical quality. The system measures the change in visual acuity (VA) over time automatically in aqueous-de?cient DE and short tear breakup tear ?lm DE characterized by decreased tear stability and minimal epithelial damage. It is also useful to detect minimal visual deterioration correlated with minimal ocular surface abnormality and vision-related quality of life otherwise undetectable by conventional VA testing, to assess and quantify vision-related symptomatology, and to determine the ef?cacy of treatments for DE disease. Recently, its use has been expanded, such as for the analysis of visual function accompanying lens, cataract and cataract-related disease, retinal disease, refractive surgery, contact glaucoma, amblyopia, presbyopia, and vehicle driving. Its use has revealed that FVA re?ects not only visual function related to tear dynamics, but also visual function related to quick recognition of the target. This simple, noninvasive, and sensitive FVA measurement system may be expected to be used worldwide.
关键词： tear film,visual function,dry eye,functional visual acuity,tear breakup time
更新于2025-09-09 09:28:46
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Maximum Reading Speed in Patients With Geographic Atrophy Secondary to Age-Related Macular Degeneration
摘要： PURPOSE. Geographic atrophy (GA) is an advanced form of age-related macular degeneration. GA often initially spares the center of the fovea, leading to a functional disconnect between reading speed and distance visual acuity. This study was designed to determine the correlation between baseline GA lesion size, change in lesion size, and maximum reading speed (MRS) over 18 months. METHODS. Post hoc analysis included US patients from the phase 2 Mahalo study of intravitreal lampalizumab with Minnesota low-vision reading (MNREAD) assessments at baseline and 6, 12, and 18 months. Binocular MRS was assessed using MNREAD Acuity Charts and GA lesion size by fundus autofluorescence. Correlations were estimated using Spearman’s rank correlation coefficient. RESULTS. Seventy-seven patients were included in the analysis. Baseline MRS correlated with baseline GA lesion size (correlation coefficient, (cid:2)0.47; 95% confidence interval, (cid:2)0.63 to (cid:2)0.28; P < 0.0001). In patients with lesions ?10 mm2 (four disc areas), the proportion reading below a nonfluent level (MRS, <40 words/min) at baseline (26.5%) increased to 64.7% by 18 months, versus patients with lesions <10 mm2 (baseline, 9.3%; 18 months, 7.0%). MRS declined by a median of 40.9% (interquartile range [IQR], (cid:2)70.2 to (cid:2)6.9) in patients with ?2.5 mm2 lesion growth versus 8.2% (IQR, (cid:2)34.6 to 11.0) in patients with <2.5 mm2 lesion growth from baseline to 18 months. CONCLUSIONS. These findings suggest that baseline GA lesion size and magnitude of lesion growth are associated with a decline in MRS over time and support the use of MRS as an evaluation of functional vision in patients with GA.
关键词： quality of life,maximum reading speed,visual function,geographic atrophy
更新于2025-09-04 15:30:14