Mapping of central visual function by microperimetry and autofluorescence in patients with Best's vitelliform dystrophy

Abstract

Purpose To evaluate retinal sensitivity and fixation patterns in patients with Best's dystrophy by microperimetry (MP) and to correlate the results with static perimetry and retinal morphology seen by autofluorescence (AF). Methods Central 101 visual fields in 11 patients with Best's dystrophy (VA: 0.570.38) were recorded by the Octopus M2 TOP program and by MP (MP1, Nidek Technologies). AF was recorded by HRA (Heidelberg Engineering). Results High correlation (R ¼ 0.75, À0.76, À0.48) was found between static perimetry (MS, MD and CLV indices) and MP. Based on MP and AF results, three groups of patients were formed. Patients in the first two groups fixated inside the central nonuniform hypoand hyperfluorescent AF ring area, next to relative (Group 1) or absolute scotoma (Group 2). Inner parts of the retina close to the fovea were most affected, whereas regions closer to the periphery of the 101 visual field showed near normal function. As the disease progressed, there was an evident shift of fixation to preferential retinal locus (PRL) in eight eyes with visual acuity 0.2 or less (Group 3). Fixation shift was superior in four eyes, temporal in two eyes, and nasal in two eyes. Conclusion MP enabled a highly sensitive topographic monitoring of retinal function, showing central or pericentral fixation in the early stages, until loss of central function, in eyes with VA 0.2 or less, caused evident shift of fixation to PRL. PRL was never situated inside the central uniform hypofluorescent area, but corresponded with the hyperfluorescent ring seen with AF imaging.

Best vitelliform macular dystrophy: literature review

“…PRL was never situated inside the central uniform hypofluorescent area, but corresponded with the hyperfluorescent ring seen by the autofluorescence imaging [28]. Progression of BVD, indicated with deterioration of VA and more dense central scotomas were detected with static perimetry, which showed a high correlation with MP results [28].…”

“…High correlation (R=0.75, -0.76, -0.48) was found between static perimetry (MS, MD and CLV indices) and MP [28]. Results showed that microperimetry enabled a highly sensitive topographic monitoring of retinal function, showing central or pericentral fixation in the early stages, until loss of central function, in the eyes with visual acuity 0.2 or less has caused evident shift of fixation to preferential retinal locus (PRL) [28]. PRL was never situated inside the central uniform hypofluorescent area, but corresponded with the hyperfluorescent ring seen by the autofluorescence imaging [28].…”

“…Results showed that microperimetry enabled a highly sensitive topographic monitoring of retinal function, showing central or pericentral fixation in the early stages, until loss of central function, in the eyes with visual acuity 0.2 or less has caused evident shift of fixation to preferential retinal locus (PRL) [28]. PRL was never situated inside the central uniform hypofluorescent area, but corresponded with the hyperfluorescent ring seen by the autofluorescence imaging [28]. Progression of BVD, indicated with deterioration of VA and more dense central scotomas were detected with static perimetry, which showed a high correlation with MP results [28].…”

“…Jarc-Vidmar M et al evaluated mapping of central visual function by microperimetry (MP) and autofluorescence in patients with Best's vitelliform dystrophy [28]. High correlation (R=0.75, -0.76, -0.48) was found between static perimetry (MS, MD and CLV indices) and MP [28]. Results showed that microperimetry enabled a highly sensitive topographic monitoring of retinal function, showing central or pericentral fixation in the early stages, until loss of central function, in the eyes with visual acuity 0.2 or less has caused evident shift of fixation to preferential retinal locus (PRL) [28].…”

“…Pacients have good visual acuity but later visual fields may show subtle central sensitity losses, while peripheral visual field is normal [26,27]. Jarc-Vidmar M et al evaluated mapping of central visual function by microperimetry (MP) and autofluorescence in patients with Best's vitelliform dystrophy [28]. High correlation (R=0.75, -0.76, -0.48) was found between static perimetry (MS, MD and CLV indices) and MP [28].…”