DISTORTION MAPS FROM PREFERENTIAL HYPERACUITY PERIMETRY ARE HELPFUL IN MONITORING FUNCTIONAL RESPONSE TO LUCENTIS THERAPY

Abstract

To use preferential hyperacuity perimetry to obtain a quantitative measure of central visual field distortion that would aid in the monitoring of functional responsiveness to ranibizumab treatment. This study is a retrospective analysis of data from patients with neovascular age-related macular degeneration treated with ranibizumab. Preferential hyperacuity perimetry (PHP) were performed before and within 10 days of treatment. Pre- and posttreatment PHP metamorphopsia maps of contours showing 6 levels of metamorphopsia severity (S1 through S6; least to most distortion) were analyzed. Optical coherence tomography (OCT) outputs were subjected to standardized grading to generate metrics on subretinal fluid height, maximum retinal thickness, outer high-reflectivity band thickness, and height of pigment epithelial detachment (OCT metrics). Complete data were available from 17 patients. Statistically significant reductions were seen between baseline and posttreatment in PHP contour areas and OCT metrics, except for maximum retinal thickness. Mean best-corrected visual acuity improved by two letters, but this was not statistically significant. Change in PHP parameters correlated strongly with change in subretinal fluid height, with P values of <0.01 for most comparisons. Change in best-corrected visual acuity did not correlate with change in any of the OCT metrics or PHP distortion map areas. The reduction in the contour map area seen on PHP outputs occurs rapidly and correlates with the resolution of subretinal fluid, suggesting that this parameter may be used to monitor response to therapy.