Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Heraklion, Greece.
Optom Vis Sci. 2023 Oct 1;100(10):670-678. doi: 10.1097/OPX.0000000000002064. Epub 2023 Aug 29.
Functional vision, as evaluated with silent passage reading speed, improves after anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with wet age-related macular antidegeneration (wAMD), reflecting primarily a concomitant reduction in the number of fixations. Implementing eye movement analysis when reading may better characterize the effectiveness of therapeutic approaches in wAMD.
This study aimed to evaluate silent reading performance by means of eye fixation analysis before and after anti-VEGF treatment in wAMD patients.
Sixteen wAMD patients who underwent anti-VEGF treatment in one eye and visual acuity (VA) better than 0.5 logMAR served as the AMD group. Twenty adults without ocular pathology served as the control group. Central retinal thickness and near VA were assessed at baseline and 3 to 4 months after their first visit. Reading performance was evaluated using short passages of 0.4-logMAR print size. Eye movements were recorded using EyeLink II video eye tracker. Data analysis included computation of reading speed, fixation duration, number of fixations, and percentage of regressions. Frequency distributions of fixation durations were analyzed with ex-Gaussian fittings.
In the AMD group, silent reading speed in the treated eye correlated well with central retinal thickness reduction and improved significantly by an average of 15.9 ± 28.5 words per minute (P = .04). This improvement was accompanied by an average reduction of 0.24 ± 0.38 in fixations per word (P = .03). The corresponding improvement in monocular VA was not statistically significant. Other eye fixation parameters did not change significantly after treatment. No statistically significant differences were found in the control group.
Visual acuity tests may underestimate the potential therapeutic effects after anti-VEGF treatment in patients with relatively good acuity who are being treated for wAMD. Evaluating silent reading performance and eye fixation parameters may better characterize the effectiveness of therapeutic approaches in wAMD patients.
在湿性年龄相关性黄斑变性（wAMD）患者中，经抗血管内皮生长因子（抗-VEGF）治疗后，通过无声阅读速度评估的功能性视力得到改善，这主要反映了注视次数的同时减少。在阅读时实施眼动分析可能会更好地描述 wAMD 治疗方法的有效性。
本研究旨在评估 wAMD 患者接受抗-VEGF 治疗前后通过眼固视分析进行的无声阅读表现。
16 名接受单眼抗-VEGF 治疗且视力（VA）优于 0.5 logMAR 的 wAMD 患者作为 AMD 组。20 名无眼部病变的成年人作为对照组。在基线和首次就诊后 3 至 4 个月评估中央视网膜厚度和近 VA。使用 0.4-logMAR 打印尺寸的短段落评估阅读性能。使用 EyeLink II 视频眼动追踪器记录眼动。数据分析包括计算阅读速度、注视持续时间、注视次数和回归百分比。使用外高斯拟合分析注视持续时间的频率分布。
在 AMD 组中，治疗眼的无声阅读速度与中央视网膜厚度的降低密切相关，平均提高了 15.9±28.5 个单词/分钟（P=0.04）。这种改善伴随着注视次数平均减少 0.24±0.38 个/词（P=0.03）。单眼 VA 的相应改善没有统计学意义。治疗后其他眼固视参数没有明显变化。对照组没有发现统计学上的显著差异。
在视力相对较好且正在接受 wAMD 治疗的患者中，视力测试可能低估了抗-VEGF 治疗后的潜在治疗效果。评估无声阅读表现和眼固视参数可能会更好地描述 wAMD 患者治疗方法的有效性。
