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Normal Values for Fundus Perimetry with the Microperimeter MP1
No full textNormal values for fundus perimetry with the microperimeter MP1. Midena E, Vujosevic S, Cavarzeran F; Microperimetry Study Group. Collaborators (12)Luciani F, Cappello E, Tollot L, Carpineto P, Capris P, Convento E, Midena E, Radin PP, Varano M, Vujosevic S, Tedeschi E, Parodi MB. SourceDepartment of Ophthalmology, University of Padova, Padova, Italy. [email protected] Abstract PURPOSE: To identify age-stratified normal light sensitivity values for microperimetry (fundus perimetry) and to evaluate the short-term repeatability of the MP1 microperimeter in normal volunteers. DESIGN: Multicenter, prospective, observational study. PARTICIPANTS: One hundred ninety subjects. METHODS: One hundred ninety eyes of 190 healthy volunteers (age range, 20-75 years) underwent automatic, full-threshold microperimetry of the central field (20 x 20 degrees, 77 stimulated points) with the MP1 microperimeter (Nidek Technologies, Gamagori, Japan). Fixation was documented simultaneously. A subgroup of 10 subjects was retested after 1 hour and 1 week to determine the repeatability of this technique. MAIN OUTCOME MEASURES: By linear regression analyses, light sensitivity values were obtained from 4 fundus areas and were analyzed for differences related to region, age, and, in a subset of subjects, repeat testing over time and right and left eye variability. Short-term repeatability for each area was evaluated by calculating intraclass correlation coefficients. RESULTS: Linear regression analysis showed a significantly greater (P<0.0001) mean macular sensitivity of 19.6+/-0.5 dB in the 20 to 29 years of age group compared with 18.6+/-1.5 dB in the oldest age group of 70 to 75 years. These results were confirmed by the fifth percentile of light sensitivity threshold distribution. Normal and 95% confidence interval age-stratified values were calculated. When results for all 190 subjects were analyzed by region, the superior retinal sector showed significantly lower mean sensitivity values than other sectors (P<0.01, Bonferroni test). In a subset of 10 subjects, repeatability of the test performed at 3 separate visits showed consistent values over time in all areas (P<0.01, intraclass correlation coefficients). CONCLUSIONS: Automatic fundus perimetry with the MP1 microperimeter allows for an accurate, repeatable, topographically specific examination of the retinal threshold in selected retinal areas. These findings are the first extensive database of age-related, normal MP1 microperimetry results available to clinicians. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. Comment in Ophthalmology. 2011 Jun;118(6):1224; author reply 1224-5. PMID: 20472294 [PubMed - indexed for MEDLINE
Macular automatic fundus perimetry threshold versus standard perimetry threshold
No full textMacular automatic fundus perimetry threshold versus standard perimetry threshold.
Midena E, Radin PP, Convento E, Cavarzeran F.
SourceDepartment of Ophthalmology, University of Padova, Padova; G.B. Bietti Eye Foundation, IRCCS, Roma, Italy. [email protected]
Abstract
PURPOSE: To evaluate if retinal sensitivity threshold obtained with an automatic fundus perimeter may be compared with a standard perimeter retinal threshold.
METHODS: Automatic full-threshold fundus perimetry (microperimetry) of the macular area (10 degrees grid, 37 stimulated points) was quantified with a new automatic fundus perimeter (MP1 microperimeter) in nine normal subjects (18 eyes). Retinal threshold was also quantified using an identical grid projected with a standard Octopus 101 perimeter.
RESULTS: Mean threshold registered by MP1 microperimeter was 19.7+/-0.8 dB (range 16-20 dB; 4.38+/-0.96 asb, range 4-10 asb) versus 33.1+/-1.7 dB (range 27-38 dB; 0.53+/-0.22 asb, range 0.16-2 asb) obtained with Octopus perimeter. Mean SD of intraindividual variation was 0.74 dB in MP1 and 1.51 dB in Octopus. No statistically significant differences were documented between right and left eye with both instruments (p=0.64). No reliable mathematical relationship between retinal thresholds could be obtained with the two perimeters.
CONCLUSIONS: Fundus perimetry is a precise, functional fundus-related technique which allows threshold determination at selected retinal points even if fixation is unstable and visual acuity is low. This is beyond the possibility of any static standard perimetry. Normal threshold values obtained with MP1 automatic microperimeter cannot be currently compared with those obtained with standard Octopus perimeter.
PMID: 17294384 [PubMed - indexed for MEDLINE
Microperimetry and fundus autofluorescence in patients with early age-related macular degeneration
No full textMicroperimetry and fundus autofluorescence in patients with early age-related macular degeneration.
Midena E, Vujosevic S, Convento E, Manfre' A, Cavarzeran F, Pilotto E.
SourceDepartment of Ophthalmology, University of Padova, Via Giustiani 2, 35128 Padova, Italy. [email protected]
Abstract
BACKGROUND: Early age-related macular degeneration (AMD) has been correlated with different functional alterations, but the exact relationship between fundus lesions and overlying sensitivity is not well known. The aim of this study was to compare fundus-related sensitivity (microperimetry) and fundus autofluorescence (FAF) of the macular area with drusen and pigment abnormalities in early AMD.
METHODS: 13 consecutive patients with early AMD and visual acuity of 20/20 were studied by means of microperimetry, which automatically analyses macular light differential threshold and fixation patterns. Fundus colour photo and FAF of the macular area were recorded on the same day. Microperimetry was exactly (topographically) superimposed over FAF images.
RESULTS: Macular sensitivity significantly decreased over large drusen (11.2 +/- 5.6 dB, p<0.0001) and over pigment abnormalities (13.1 +/- 3.6 dB, p<0.0001). When both characteristics were present the reduction was greater if compared with its absence (9.6 +/- 4.3 versus 15.0 +/- 4.5 dB, p<0.0001). Sensitivitity reduction was significant in areas with altered FAF when compared with areas with normal FAF (p<0.0001).
CONCLUSIONS: Increased FAF in early AMD has a functional correlate exactly quantified by microperimetry. In retinal areas affected by early AMD retinal sensitivity deteriorates, despite good visual acuity. Microperimetry may allow the early detection of functional impairment caused by these lesions. Both microperimetry and FAF may be useful to monitor AMD progression.
PMID: 17504849 [PubMed - indexed for MEDLINE] PMCID: PMC209542
Diabetic macular edema: Correlation between microperimetry and optical coherence tomography findings
Full text linkInvest Ophthalmol Vis Sci. 2006 Jul;47(7):3044-51.
Diabetic macular edema: correlation between microperimetry and optical coherence tomography findings.
Vujosevic S, Midena E, Pilotto E, Radin PP, Chiesa L, Cavarzeran F.
SourceFondazione G. B. Bietti per l'Oftalmologia, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Roma, Italy. [email protected]
Abstract
PURPOSE: To compare the changes in macular sensitivity (microperimetry) and macular thickness with different degrees of diabetic macular edema.
METHODS: Sixty-one eyes of 32 consecutive diabetic patients were included in this cross-sectional study. All included eyes underwent functional and morphologic examination of the macular area. Best corrected visual acuity (ETDRS charts), macular sensitivity, and macular thickness were quantified. Lesion-related macular sensitivity and retinal fixation were investigated with an advanced, automatic microperimeter. Optical coherence tomography (OCT) was used to quantify macular thickness.
RESULTS: The 61 included eyes were graded, by two retinal specialists, for diabetic macular edema as follows: 16 were graded as no macular edema (NE), 30 as non-clinically significant macular edema (NCSME), and 15 as clinically significant macular edema (CSME). Macular thickness significantly increased from the NE to the CSME group (P<0.0001), whereas macular sensitivity significantly decreased from the NE to the CSME group (P<0.0021). A significant correlation coefficient was noted between retinal sensitivity and normalized macular thickness (r=-0.37, P<0.0001). Linear regression analysis showed a decrease of 0.83 dB (P<0.0001) for every 10% of deviation of retinal thickness from normal values. Visual acuity and central macular sensitivity correlated significantly in the NCSME group (r=-0.6, P=0.0008), but not in the NE (r=-0.144, P=0.6) or in the CSME (r=-0.46, P=0.11) groups.
CONCLUSIONS: Macular edema may be better documented by adding macular sensitivity mapping by microperimetry to macular thickness measurement by OCT and visual acuity determination because macular sensitivity seems to be a relevant explanatory variable of visual function, independent of macular thickness data. Moreover, microperimetry may be of value in predicting the outcome of diabetic macular edema, because it incorporates a functional measure that may supplement the predictive value of OCT and visual acuity.
PMID: 16799051 [PubMed - indexed for MEDLINE]
IF 2008: 3.582 - quartile superiore, punti 1
Screening for diabetic retinopathy: 1 and 3 nonmydriatic 45-degree digital fundus photographs vs 7 standard early treatment diabetic retinopathy study fields.
No full textAm J Ophthalmol. 2009 Jul;148(1):111-8. Epub 2009 May 5.
Screening for diabetic retinopathy: 1 and 3 nonmydriatic 45-degree digital fundus photographs vs 7 standard early treatment diabetic retinopathy study fields.
Vujosevic S, Benetti E, Massignan F, Pilotto E, Varano M, Cavarzeran F, Avogaro A, Midena E.
Source
Fondazione G.B. Bietti per l'Oftalmologia, IRCCS (Istituto di Ricovero e Cura a Carattere Scientificio), Roma, Italy.
Abstract
PURPOSE:
To evaluate if simple- or multiple-field digital color nonmydriatic (NM) retinal images can replace 7 standard stereoscopic fundus photographs in the screening of diabetic retinopathy (DR).
DESIGN:
Prospective, masked, comparative case series.
METHODS:
One hundred and eight eyes of 55 diabetics were studied to determine single lesions and to grade clinical levels of DR and diabetic macular edema (DME) using both 1 and 3 NM digital color retinal images compared with the Early Treatment Diabetic Retinopathy Study (ETDRS) 7 standard 35-mm stereoscopic color fundus photographs (7F-ETDRS). All eyes underwent NM 45-degree field images of 1 central field (1F-NM), NM 45-degree field images of 3 fields (3F-NM), and, after pupil dilatation, 30-degree 7F-ETDRS photography. Images were analyzed by 2 independent, masked retinal specialists (S.V. and E.B.), lesion-by-lesion according to the ETDRS protocol and for clinical severity level of DR and DME according to the international classification of DR.
RESULTS:
Using 7F-ETDRS as the gold standard, agreement was substantial for grading clinical levels of DR and DME (kappa = 0.69 and kappa = 0.75) vs 3F-NM; moderate for DR level (kappa = 0.56) and substantial for DME (kappa = 0.66) vs 1F-NM; almost perfect for detecting presence or absence of DR (kappa = 0.88) vs both 1F-NM and 3F-NM; and almost perfect for presence or absence of DME (kappa = 0.97) vs 3F-NM and substantial (kappa = 0.75) vs 1F-NM. Sensitivity and specificity for detecting referable levels of DR were 82% and 92%, respectively, for 3F-NM and 71% and 96%, respectively, for 1F-NM.
CONCLUSIONS:
Three color 45-degree NM fundus fields may be an effective tool in a screening setting to determine critical levels of DR and DME for prompt specialist referral. One central 45-degree image is sufficient to determine absence or presence of DR and DME, but not for grading it
Metagenomic analysis of the conjunctival bacterial and fungal microbiome in vernal keratoconjunctivitis
No full textEfficacy and Satisfaction of Cyclosporine 0.1% in Patients with Vernal Keratoconjunctivitis
No full textVernal keratoconjunctivitis (VKC) is a severe form of ocular allergy that compromises the quality of life of affected patients. Topical cyclosporine 0.1% cationic emulsion (CsA-CE) has been recently authorized for the treatment of severe VKC. We treated 29 VKC patients with on-label CsA-CE and recorded signs and symptoms, subjective patient’s treatment satisfaction and the additional use of topical corticosteroids in case of exacerbations. CsA-CE was effective in reducing signs and symptoms in daily clinical practice. The overall subjective improvement of symptoms, efficacy of the treatment, tolerability to the drug and compliance reached a high level of subjective satisfaction score.55% of treated patients required the additional use of a 3-day course of topical dexamethasone with 1.13 ± 0.81 mean courses/month. In conclusions, VKC patients reported an overall high satisfaction with used the on-label topical CsA-CE with a limited use of additional topical corticosteroid treatment
Macular and peripapillary choroidal thickness in diabetic patients.
Full text linkPURPOSE:
: To investigate macular and peripapillary choroidal thickness (CT) in diabetic patients with and without diabetic retinopathy (DR).
METHODS:
: One hundred and fifty subjects were enrolled: 102 diabetic patients (102 eyes) and 48 normals, as controls. Exclusion criteria were previously treated DR, refractive error higher than ±3 diopters, and treated or untreated glaucoma. All patients underwent full ophthalmic examination, stereoscopic color fundus photography, and spectral domain optical coherence tomography (RS-3000; Nidek). Spectral domain optical coherence tomography examination consisted of linear scans, 6 mm in length, centered onto the fovea, and circle scan positioned around the optic disk (3.46 mm in diameter). Choroidal thickness was measured manually at the fovea and at 1, 2, and 3 mm distance along all scans in the macula. Peripapillary CT was measured at eight points along the circle scan. All measurements were performed independently by 2 masked graders.
RESULTS:
: Mean age was not significantly different between patients with diabetes and controls. In the macular area, CT was significantly lower in the nasal quadrant versus all other quadrants (P < 0.0001), in both groups. In the peripapillary area, CT was significantly lower in the inferior quadrant versus all other quadrants (P < 0.05), in both groups. Mean macular and peripapillary CT progressively and significantly decreased with increasing level of DR (nonproliferative and proliferative DR vs. controls, P < 0.05). No significant CT difference was found between controls and diabetic eyes without detectable DR. Diabetic macular edema did not influence CT. Interobserver coefficient of repeatability was 28.8 (95% confidence interval, 24.8-32.8) for foveal measurements and 13.0 (95% confidence interval, 11.2-14.8) for peripapillary measurements. Pearson correlation coefficient was 0.99, and P <0.0001 for all measurements.
CONCLUSION:
: Choroidal thickness is reduced in diabetic eyes and parallels appearance and evolution of DR. Spectral domain optical coherence tomography clearly confirms in vivo previously reported histopathologic observations. The role of choroid in the pathophysiology of DR needs to be adequately investigated
SUBTHRESHOLD MICROPULSE YELLOW LASER VERSUS SUBTHRESHOLD MICROPULSE INFRARED LASER IN CENTER-INVOLVING DIABETIC MACULAR EDEMA: Morphologic and Functional Safety.
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