Schneider U, Inhoffen W, Gelisken F, Kreissig I
Department of Ophthalmology III, University Eye Clinic, Tübingen, Germany.
Graefes Arch Clin Exp Ophthalmol. 1996 Oct;234(10):612-7. doi: 10.1007/BF00185293.
Clinical management and treatment of diseases with choroidal neovascularization (CNV) are mainly based on visual acuity, which may give an incomplete picture of the associated visual dysfunctions. With the advent of new experimental treatment modalities such as alfa-interferon, radiation, or surgical excision of CNV, it is increasingly important to develop better methods for characterizing the associated visual function. Microperimetry with the scanning laser ophthalmoscope (SLO) allows precise point-to-point correlation between visual function and the macular pathology. However, precise delineation of CNV is a prerequisite for accurate correlation of the functional results with the CNV.
A total of 40 eyes with CNV secondary to age-related macular degeneration were evaluated with static manual microperimetry using the SLO to quantitate relative and absolute scotomata within the CNV. For precise delineation of the CNV, indocyanine green (ICG) angiography was simultaneously performed, allowing stimulus presentation at any desired retinal location under visual feedback of the angiogram.
A relative scotoma was detected in 19 and an absolute scotoma in 21 out of 40 eyes. The depth of the scotomata was correlated with the duration of symptoms (P < 0.01). Eyes with well-defined CNV had significantly deeper scotomas than eyes with occult CNV (P < 0.005).
Microperimetry using the SLO and simultaneous ICG angiography demonstrated relative and absolute scotoma within the CNV. The depth of the scotoma may guide the ophthalmologist in selecting the adequate treatment.
脉络膜新生血管（CNV）相关疾病的临床管理和治疗主要基于视力，而这可能无法全面反映相关的视觉功能障碍。随着α-干扰素、放射治疗或CNV手术切除等新实验性治疗方法的出现，开发更好的方法来表征相关视觉功能变得越来越重要。使用扫描激光检眼镜（SLO）进行微视野检查可实现视觉功能与黄斑病变之间精确的点对点关联。然而，精确描绘CNV是将功能结果与CNV进行准确关联的前提条件。
对40例年龄相关性黄斑变性继发CNV的患眼进行评估，使用SLO通过静态手动微视野检查来定量CNV内的相对和绝对暗点。为精确描绘CNV，同时进行吲哚菁绿（ICG）血管造影，以便在血管造影视觉反馈下于任何所需视网膜位置呈现刺激。
40眼中，19眼检测到相对暗点，21眼检测到绝对暗点。暗点深度与症状持续时间相关（P < 0.01）。CNV明确的患眼暗点明显比隐匿性CNV患眼深（P < 0.005）。
使用SLO和同步ICG血管造影的微视野检查显示了CNV内的相对和绝对暗点。暗点深度可为眼科医生选择适当的治疗方法提供指导。
