Meyer Carsten H, Lapolice Deborah J
Department of Ophthalmology, Philipps-University, Marburg, Germany.
Ophthalmologica. 2008;222(6):364-8. doi: 10.1159/000151246. Epub 2008 Aug 12.
To evaluate the visual acuity (VA) of patients following intravitreal (IVT) injections.
15 patients received 3 anti-vascular-endothelial-growth-factor (VEGF) injections on a monthly basis. Prior to each injection as well as 2 months after, the patients received a standardized examination including Snellen VA and optical coherence tomography (OCT). During this time the patients were trained to evaluate their central VA by 3 computer-based tests: (a) VA was examined by the patient on a computer-based vision chart and (b) subjectively categorized as 'same', 'worse' or 'better'; (c) the edge of metamorphopsia was outlined on a digital Amsler grid.
VA improved during the 3 injections by >or=2 lines (13/15). The assessment demonstrated subjective improvement (13/15), i.e. a gain of 2 or more lines or decreased central metamorphopsia (12/15). Reevaluation 2 months later demonstrated a decline of >or=1 Snellen line or increased retinal thickness on OCT (8/15), and a decline of >or=1 line or an enlarged metamorphopsia in the computer-based tests (6/15).
Our pilot study demonstrated a good correlation between the professional examination and the computer-based assessment. Selected patients can define their visual impairment. A web-based VA evaluation may help to screen patients after IVT injections on a regular basis at home.
评估玻璃体内(IVT)注射后患者的视力(VA)。
15名患者每月接受3次抗血管内皮生长因子(VEGF)注射。在每次注射前以及注射后2个月,患者接受包括Snellen视力和光学相干断层扫描(OCT)在内的标准化检查。在此期间,患者通过3项基于计算机的测试接受训练以评估其中心视力:(a)患者在基于计算机的视力表上检查视力;(b)主观分类为“相同”、“更差”或“更好”;(c)在数字Amsler网格上勾勒出变视症的边缘。
在3次注射期间,15名患者中有13名的视力提高了≥2行。评估显示主观改善(15名患者中有13名),即视力提高2行或更多行或中心变视症减轻(15名患者中有12名)。2个月后的重新评估显示,15名患者中有8名在OCT上Snellen视力下降≥1行或视网膜厚度增加,15名患者中有6名在基于计算机的测试中视力下降≥1行或变视症扩大。
我们的初步研究表明专业检查与基于计算机的评估之间具有良好的相关性。选定的患者能够确定其视力损害情况。基于网络的视力评估可能有助于在家中定期对接受IVT注射后的患者进行筛查。