The correlation between retinal sensitivity assessed by microperimetry and contrast sensitivity in diabetic macular oedema

Kim, Young Ho; Yun, Cheolmin; Kim, Jee Taek; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

doi:10.1136/bjophthalmol-2013-304765

Cited by 18 publications

(12 citation statements)

References 25 publications

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“…Retinal thinning has been suggested to correlate with retinal dysfunction in diabetic patients. 23 , 35 , 36 , 44 Similar to previous studies, we found structural evidence of retinal neurodegeneration by the thinner GCL+IPL in diabetic patients. 10 , 25 , 30 , 31 , 35 We also found that diabetes differentially affects other layers of the retina.…”

Section: Discussionsupporting

confidence: 90%

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

Joltikov

Castro

Dávila

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeTo test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease.MethodsFifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP).ResultsETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function.ConclusionsThis multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies.

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Section: Discussionsupporting

confidence: 90%

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

Joltikov

Castro

Dávila

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…It is being increasingly used to monitor a variety of conditions including CHM, achromatopsia, AMD, and diabetes 5,7–10. It has been correlated to contrast sensitivity11 as well as to optical coherence tomography (OCT) appearance 12. The anticipated potential benefits of using microperimetry as an outcome measure in CHM gene therapy clinical trials include accurate threshold sensitivity mapping at individual retinal points over time (e.g., in the region exposed to a subretinal delivery of viral vector), and automated adjustments for eye movements that may compensate for fixation losses related to poor VA.…”

mentioning

confidence: 99%

Characterizing the Natural History of Visual Function in Choroideremia Using Microperimetry and Multimodal Retinal Imaging

Jolly

Xue

Edwards

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeCentripetal retinal degeneration in choroideremia (CHM) leads to early visual field restriction and late central vision loss. The latter marks an acute decline in quality of life but visual prognostication remains challenging. We investigated visual function in CHM by correlating best-corrected visual acuity (BCVA), microperimetry and multimodal imaging.MethodsFifty-six consecutive CHM patients attending Oxford Eye Hospital were examined with BCVA, 10–2 microperimetry, optical coherence tomography, and fundus autofluorescence (AF). Microperimetry was repeated in 21 eyes and analyzed with Bland-Altman. Kaplan-Meier survival plots of eyes retaining 20/20 BCVA were created. Intereye symmetry was assessed.ResultsMicroperimetry coefficient of repeatability was 1.45 dB. Survival analysis showed an indistinguishable pattern between eyes (median survival 39 years). Macular sensitivity showed a similar decline in right and left eyes, with half-lives of 13.6 years. Zonal analysis showed faster decline nasal to the fovea. Intereye symmetry was more consistent for microperimetry sensitivity (r = 0.95, P < 0.001) than BCVA (r = 0.42, P = 0.0006). Near normal foveal sensitivity was maintained when the fovea was at least 2500 μm from the advancing edge of AF.ConclusionsBCVA is a marker of central degeneration and can provide valuable information about the position of the remaining retina as well as a measure of the impact on daily living. Microperimetry represents the global macular region. Both visual functions showed a high degree of intereye symmetry, particularly in early stages, indicating the fellow eye can provide a suitable control for assessing interventions to one eye. The findings may help to tailor visual prognosis and interpret outcomes of trials.

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“…Contrast sensitivity and RS are considered to be complementary tools in functional vision evaluation in DME. 20 Vujosevic et al 21 have previously found macular microperimetry to be an excellent additional tool to add to BCVA and CMT as a factor explaining visual function in patients with DME; they had also demonstrated a significant change in microperimetry results in patients with normalizing macular thickness in center-involving DME. Mastropasqua et al 22 have found that RS, as measured by microperimetry, improved after dexamethasone implantation as early as 1–4 months after the injection.…”

Section: Discussionmentioning

confidence: 99%

Macular edema resolution assessment with implantable dexamethasone in diabetic retinopathy (MERIT): a pilot study

Chhablani

Jhingan

Goud

et al. 2018

OPTH

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PurposeThis study aimed to evaluate the effect of dexamethasone implantation on the hard exudates (HEX) in patients with diabetic macular edema (DME).Study designThis was a nonrandomized open-label single-center prospective trial.MethodsThis study included 15 eyes of 11 subjects with DME. Key inclusion criteria were naïve eyes with DME with HEX within 3 mm of fovea with center-involving DME; central macular thickness (CMT) >250 μm at baseline; best-corrected visual acuity (BCVA) between 20/400 and 20/40. Key exclusion criteria were previous intraocular surgery and history of panretinal photocoagulation (PRP) in past 4 months. The primary outcome measure was change in total HEX area at the macula (in mm2) measured by semiautomated algorithm. Secondary outcome measures were change in visual acuity, low-contrast visual acuity (LCVA), retinal sensitivity (RS) on macular microperimetry, and CMT.ResultsThe total HEX area reduced from 1.5 mm2 (±1.46 mm2) at baseline to 0.89 mm2 (±1.062 mm2) at the final visit (p=0.185). The CMT improved significantly (p=0.03) from 488.67 μm (±240.66 μm) to 326.93 μm (±135.84 μm) at the final visit. Mean BCVA remained stable (p=0.95) (50.93±16.65 at baseline and 50.6±18.95 at final visit). The mean LCVA and RS showed insignificant improvement (p=0.31 and p=0.28, respectively).ConclusionOur pilot study demonstrated an improving trend in reduction of total HEX area and other anatomical outcomes, with limited functional outcomes. Larger randomized studies with a larger sample size with a control group are warranted to establish management protocols for DME with significant subfoveal HEX.

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The correlation between retinal sensitivity assessed by microperimetry and contrast sensitivity in diabetic macular oedema

Abstract: CS and RS showed moderately significant correlations in CSME. However, neither CS nor RS was correlated with RT in patients with CSME. It could be that CS and MP are complementary to each other and are useful tools in the evaluation of functional vision.

Cited by 18 publications

References 25 publications

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

Characterizing the Natural History of Visual Function in Choroideremia Using Microperimetry and Multimodal Retinal Imaging

Macular edema resolution assessment with implantable dexamethasone in diabetic retinopathy (MERIT): a pilot study

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