Laser and Retinal Research Unit, Department of Ophthalmology, King's College Hospital, London, United Kingdom.
Am J Ophthalmol. 2012 Mar;153(3):490-496.e1. doi: 10.1016/j.ajo.2011.08.034. Epub 2011 Nov 8.
To correlate the anatomic features of the macula with functional parameters like location and stability of fixation in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab injections.
Retrospective analysis.
The location and stability of fixation were determined in 41 eyes of 41 patients treated with ranibizumab for neovascular age-related macular degeneration for at least 12 months. All patients underwent 3 injections of ranibizumab 1 month apart and were retreated according to predefined criteria. The fixation parameters measured with microperimetry were correlated to visual acuity, qualitative measures on optical coherence tomography, and patterns of autofluorescence.
The location of fixation was predominantly central in 68.29%, poor central in 2.4%, and predominantly eccentric in 29.27%. The fixation was stable in 80.5%, relatively unstable in 7.3%, and unstable in 12.2%. The factors that determined central and stable location of fixation were better visual acuity (P = .004), absence of subretinal thickening (P = .003), intact subfoveal third hyperreflective band (P = .006), and intact external limiting membrane (P = .036). Autofluorescence pattern within the 4-degree circle of fovea did not correlate with fixation characteristics. However, complete absence of autofluorescence in this area was a poor prognostic indicator for central fixation.
Anatomic characteristics of the macula determine fixation patterns in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab injections. Further studies focused on eyes with complete absence of autofluorescence in the central 4-degree circle of fovea may help to define the disease characteristics in this group.
探讨接受玻璃体内雷珠单抗注射治疗的新生血管性年龄相关性黄斑变性患者的黄斑解剖特征与注视位置和稳定性等功能参数之间的相关性。
回顾性分析。
对 41 例（41 只眼）接受雷珠单抗治疗的新生血管性年龄相关性黄斑变性患者至少 12 个月的注视位置和稳定性进行了评估。所有患者均接受了 3 次每月 1 次的雷珠单抗注射治疗，并根据预定义标准进行了再治疗。用微视野计测量的注视参数与视力、光学相干断层扫描的定性测量值和自发荧光模式相关联。
注视位置以中心为主（68.29%）、中央不良（2.4%）和以偏心为主（29.27%）。注视稳定者占 80.5%，相对不稳定者占 7.3%，不稳定者占 12.2%。决定中央和稳定注视位置的因素是较好的视力（P =.004）、无视网膜下增厚（P =.003）、完整的中心凹下 3 层强反射带（P =.006）和完整的外界膜（P =.036）。4 度中心凹范围内的自发荧光模式与注视特征无关。然而，该区域完全无自发荧光是中央注视的预后不良指标。
接受玻璃体内雷珠单抗注射治疗的新生血管性年龄相关性黄斑变性患者的黄斑解剖特征决定了其注视模式。进一步研究集中在中心 4 度范围内完全无自发荧光的眼，可能有助于明确该组疾病的特征。
