Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 38, Prague, Hradec Kralove, Czech Republic.
Department of Pathological Physiology, Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic.
Doc Ophthalmol. 2021 Aug;143(1):17-31. doi: 10.1007/s10633-020-09814-8. Epub 2021 Jan 3.
For patients with age-related macular degeneration (AMD), a special intraocular lens implantation partially compensates for the loss in the central part of the visual field. For six months, we evaluated changes in neurophysiological parameters in patients implanted with a "Scharioth macula lens" (SML; a center near high add + 10 D and peripheral plano carrier bifocal lens designed to be located between the iris and an artificial lens).
Fourteen patients (5 M, 9 F, 63-87 years) with dry AMD were examined prior to and at 3 days after, as well as 1, 2, and 6 months after, implantation using pattern-reversal, motion-onset, and cognitive evoked potentials, psychophysical tests evaluating distant and near visual acuity, and contrast sensitivity.
Near visual acuity without an external aid was significantly better six months after implantation than before implantation (Jaeger table median (lower; upper quartile): 4 (1; 6) vs. 15 (13; 17)). Distant visual acuity was significantly altered between the pre- (0.7 (0.5; 0.8) logMAR) and last postimplantation visits (0.8 (0.7; 0.8) logMAR), which matched prolongation of the P100 peak time (147 (135; 151) ms vs. 161 (141; 166) ms) of 15 arc min pattern-reversal VEPs and N2 peak time (191.5 (186.5; 214.5) ms vs. 205 (187; 218) ms) of peripheral motion-onset VEPs.
SML implantation significantly improved near vision. We also observed a slight but significant decrease in distant and peripheral vision. The most efficient electrophysiological approach to test patients with SML was the peripheral motion-onset stimulation, which evoked repeatable and readable VEPs.
对于年龄相关性黄斑变性（AMD）患者，特殊的眼内晶状体植入术部分补偿了视野中心部分的损失。我们在六个月的时间里，评估了植入“Scharioth 黄斑镜”（SML；一种中心近高加 10 D，周边平载双焦点镜片，设计为位于虹膜和人工晶状体之间）的患者神经生理参数的变化。
14 名患者（5 名男性，9 名女性，63-87 岁）患有干性 AMD，在植入前、植入后 3 天、植入后 1、2 和 6 个月时，使用图形反转、运动起始和认知诱发的电位、评估远视力和近视力以及对比敏感度的心理物理测试进行检查。
植入后六个月，无需外部辅助的近视力明显优于植入前（Jager 表中位数（下限；上限四分位数）：4（1；6）与 15（13；17））。远视力在植入前（0.7（0.5；0.8）logMAR）和最后一次植入后就诊之间发生了显著变化（0.8（0.7；0.8）logMAR），这与 P100 峰时间（147（135；151）ms 与 161（141；166）ms）的延长相匹配，15 弧分图形反转 VEPs 和 N2 峰时间（191.5（186.5；214.5）ms 与 205（187；218）ms）外周运动起始 VEPs。
SML 植入术显著改善了近视力。我们还观察到远视力和周边视力略有但显著下降。测试 SML 患者最有效的电生理方法是外周运动起始刺激，它可以诱发可重复和可读的 VEP。
