Longitudinal comparison of visual acuity as measured by the ETDRS chart and by the potential acuity meter in eyes with macular edema, and its relationship with retinal thickness and sensitivity

Abstract

Purpose To evaluate the relationship between visual acuity as measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and by the potential acuity meter (PAM) with retinal thickness and sensitivity measured by a combined microperimetry/optical coherence tomography system (OCT). Methods Forty-four patients with macular edema (ME) were included in a prospective observational study. Visual acuity (VA) was assessed using the ETDRS chart (with best correction) as well as by the PAM. Retinal thickness and sensitivity was measured by an automatic fundus perimetry/tomography system. Results Best-corrected VA using the ETDRS chart ranged from 20/20 to 20/400 (median: 20/50). VA measured by the PAM without correction ranged from 20/20 to 20/400 (median: 20/40). The mean retinal thickness was 369.57 mm (s.d.: 140.28 mm) on spectral domain-OCT and the mean retinal sensitivity was 8.12 decibels (dB) (s.d.: 5.78 dB). The mean LogMAR value using the ETDRS chart was 0.43, whereas it was 0.38 using the PAM (P-value: 0.009).Conclusions VA values measured by the PAM were statistically significantly better than those measured by the ETDRS chart in eyes with ME secondary to various retinal vascular and uveitic diseases. VA measured by the PAM may be a more sensitive predictor of macular function than that obtained by ETDRS testing in eyes with ME.

Visual rehabilitation training in a patient with large central scotoma due to Leber’s hereditary optic neuropathy

“…There are studies describing visual acuity and fixation stability improvement by visual rehabilitation, using microperimeter MAIA, in patients with successful closure of macular hole [7], AMD [8] and another studies carried out on the device MP-1 in patients with myopic macular degeneration and other macular diseases [9][10][11]. Additionally, it has been proven that microperimetry is a useful tool for www.journals.viamedica.pl/ophthalmology_journal the follow-up of patients with diabetic retinopathy [12][13][14][15], central serous chorioretinopathy [16,17], uveitic macular edema [18], macular dystrophies such as Stargardt disease [19], and AMD, in the latter evidencing a decrease in retinal sensitivity and fixation quality when the disease progresses [20]. There are also studies presenting microperimetry (MP-1) diagnostic utility in the evaluation of the disorders of the optic nerve such as epidemic optic neuropathy (EON) [21][22][23][24][25][26], dominant optic atrophies (DOA) [27,28], LHON [26][27][28][29][30], thyroid associated orbitopathy to the (TAO) [27,28,31] and multiple sclerosis [27,28,32].…”

Two-Photon Microperimetry: A Media Opacity-Independent Retinal Function Assay

“…VA testing using ETDRS charts has proven to be a poor predictor of macular function in patients with macular edema secondary to retinal vascular disease, in part due to anterior or posterior segment opacities. 7 Cataractous lenses decrease the sensitivity threshold of all three cone classes due to increased scatter and decreased transmittance of visible light, 8 – 11 with the greatest impact on short-wavelength cones, especially after the age of 60. 11 , 12 Because of this effect, Fujikawa et al 13 established that CCT can be used reliably up to the seventh decade of life and after cataract surgery in elderly patients.…”