John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia.
Academic Unit, ANU Medical School, ANU, Canberra, Australia Capital Territory, Australia.
Transl Vis Sci Technol. 2021 Dec 1;10(14):24. doi: 10.1167/tvst.10.14.24.
The purpose of this study was to compare central versus peripheral retinal sensitivities and delays in neovascular age-related macular degeneration (nAMD) using US Food and Drug Administration (FDA)-cleared multifocal pupillographic objective perimetry (mfPOP).
We recruited 18 patients with nAMD and commenced Pro re nata intravitreal anti- vascular endothelial growth factor (VEGF) injection. We compared macular (±15 degrees) and wide-field (±30 degrees) mfPOP variants. We examined temporal correlations between treated and untreated fellow eyes. We fitted linear models to selected treatment patterns, and compared the ability of central versus peripheral responses to predict the need for treatment.
Central sensitivity decreased by -2.23 ± 0.051 dB/month (P < 0.0002) in treated eyes, and -0.17 ± 0.07 dB/month (P = 0.033) in untreated eyes. Treated eyes showed quicker central responses by 13.08 ± 3.77 ms than untreated eyes (P = 0.001). Based on peripheral responses, we identified two eye-types. Among positive-eyes peripheral sensitivity increased by 9.88 ± 4.41 dB (P = 0.042) before treatment; delays increased by 3.49 ± 1.75 ms/month (P = 0.049). For negative-eyes peripheral delays were shorter a month before treatment by 9.38 ± 3.59 ms (P = 0.013). Correlations between treatment and peripheral sensitivities or delays peaked at 1 to 2 months post-treatment. Peripheral data significantly determined treatment frequency and final acuity (all P < 0.044).
Peripheral macular function of treated and untreated eyes divided eyes into positive and negative groups. Those peripheral responses determined outcomes; changes preceding active disease by 1 to 3 months. Overall, mfPOP may provide potential biomarkers to assist nAMD management.
Objective perimetry may identify the requirement for treatment in nAMD that accords with the decision of a skilled clinician based on optical coherence tomography (OCT) and clinical findings.
本研究旨在使用美国食品和药物管理局（FDA）批准的多焦瞳孔计客观视野计（mfPOP）比较新生血管性年龄相关性黄斑变性（nAMD）的中心和周边视网膜敏感性及延迟。
我们招募了 18 名 nAMD 患者，并开始进行 Pro re nata 玻璃体内抗血管内皮生长因子（VEGF）注射。我们比较了黄斑（±15 度）和宽视野（±30 度）mfPOP 变体。我们检查了治疗眼和未治疗眼之间的时间相关性。我们为选定的治疗模式拟合线性模型，并比较了中心和周边反应预测治疗需求的能力。
治疗眼的中心敏感性每月下降-2.23 ± 0.051 dB（P < 0.0002），未治疗眼下降-0.17 ± 0.07 dB/月（P = 0.033）。治疗眼的中央反应比未治疗眼快 13.08 ± 3.77 ms（P = 0.001）。根据周边反应，我们确定了两种眼型。在治疗前，阳性眼的周边敏感性增加了 9.88 ± 4.41 dB（P = 0.042）；延迟增加了 3.49 ± 1.75 ms/月（P = 0.049）。对于阴性眼，治疗前一个月的周边延迟缩短了 9.38 ± 3.59 ms（P = 0.013）。治疗与周边敏感性或延迟之间的相关性在治疗后 1 至 2 个月达到峰值。周边数据显著决定了治疗频率和最终视力（均 P < 0.044）。
治疗眼和未治疗眼的周边黄斑功能将眼分为阳性和阴性两组。这些周边反应决定了结果；在疾病活跃前 1 至 3 个月就出现了变化。总的来说，mfPOP 可能为 nAMD 的管理提供潜在的生物标志物。
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