Department of Ophthalmology, University of Paris XII, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Invest Ophthalmol Vis Sci. 2011 Sep 1;52(9):7012-8. doi: 10.1167/iovs.11-7517.
To analyze the response to anti vascular endothelial growth factor (VEGF) treatment for exudative age-related macular degeneration (AMD), with respect to changes in the Preferential Hyperacuity Perimeter (PHP), best-corrected visual acuity (BCVA), and spectral-domain optical coherence tomography (SD-OCT), and to investigate whether the PHP score predicts the need for reinjection.
Consecutive patients with newly diagnosed exudative AMD underwent the PHP metamorphopsia test, BCVA, and SD-OCT at five time points after initiation of ranibizumab therapy (0.05 mL/0.5 mg). At the third and sixth months, reevaluation for additional injections was done. The relationships between PHP, BCVA, and SD-OCT parameters over time as well as their ability to predict the need for reinjection were examined.
Analysis included 17 eyes (17 patients, 70% females; mean age, 83.2 years). The mean PHP metamorphopsia test score improved from 25.6 ± 41 (baseline) to 10.7 ± 20.1 (P < 0.05) over 6 months, after a mean of 4.2 (±1.0) injections. Mean reduction in SD-OCT parameters well reflected the functional improvements as evaluated by PHP (Spearman correlation = 0.9, P < 0.05). Mean BCVA did not improve over 6 months (0.6 vs. 0.58 logMAR), and neither correlated with SD-OCT morphologic changes (Spearman correlation = 0.1, P > 0.05) nor with PHP functional changes (Spearman correlation = 0.1, P > 0.05). The PHP predicted the need for reinjection with an accuracy of 75% (sensitivity, 83 ± 12%; specificity, 67 ± 15%), whereas a combination of all the measurements (PHP, BCVA, and SD-OCT) yielded an accuracy of 87% (sensitivity, 83 ± 12%; specificity, 90 ± 10%).
Improvement in the metamorphopsia test score after intravitreal injections of ranibizumab, as well as its ability to predict the need for retreatment, suggest that PHP may be used to monitor response to anti-VEGF therapy in patients with exudative AMD.
分析抗血管内皮生长因子（VEGF）治疗渗出性年龄相关性黄斑变性（AMD）的反应，重点关注偏好性高敏度周边视野计（PHP）、最佳矫正视力（BCVA）和光谱域光学相干断层扫描（SD-OCT）的变化，并探讨 PHP 评分是否可以预测是否需要再次注射。
连续纳入新诊断为渗出性 AMD 的患者，在开始接受雷珠单抗治疗（0.05 mL/0.5 mg）后五个时间点进行 PHP 变形觉测试、BCVA 和 SD-OCT。在第三个和第六个月，对是否需要再次注射进行重新评估。检查了 PHP、BCVA 和 SD-OCT 参数随时间的关系，以及它们预测再次注射的能力。
分析纳入了 17 只眼（17 例患者，70%为女性；平均年龄 83.2 岁）。PHP 变形觉测试评分从基线时的 25.6±41 分（平均值±标准差）改善至 6 个月时的 10.7±20.1 分（P<0.05），平均注射次数为 4.2±1.0 次。SD-OCT 参数的平均降低程度与 PHP 评估的功能改善情况很好地反映（Spearman 相关系数=0.9，P<0.05）。6 个月时平均 BCVA 没有改善（0.6 比 0.58 logMAR），与 SD-OCT 形态变化（Spearman 相关系数=0.1，P>0.05）和 PHP 功能变化（Spearman 相关系数=0.1，P>0.05）均无相关性。PHP 预测再次注射的准确率为 75%（灵敏度 83±12%；特异性 67±15%），而所有测量值（PHP、BCVA 和 SD-OCT）组合的准确率为 87%（灵敏度 83±12%；特异性 90±10%）。
玻璃体内注射雷珠单抗后，变形觉测试评分的改善及其预测再次治疗需求的能力表明，PHP 可能用于监测抗 VEGF 治疗对渗出性 AMD 患者的反应。
