Scanning laser ophthalmoscope macular perimetry in the evaluation of submacular surgery.
OBJECTIVE
Submacular surgery for choroidal neovascularization (CNV) is under investigation in the treatment of age-related macular degeneration (AMD) and the presumed ocular histoplasmosis syndrome. Four case studies are presented to demonstrate scanning laser ophthalmoscope (SLO) testing in the pre- and postsurgical evaluation of visual function in patients with subfoveal CNV secondary to AMD, presumed ocular histoplasmosis syndrome, and submacular hemorrhage secondary to AMD.


METHODS
Patients underwent a visual assessment pre- and 6 months postoperatively, consisting of low vision visual acuity measurement, SLO macular perimetry of dense and relative scotomas, and analysis of the preferred retinal locus for fixation (PRL) location and ability.


RESULTS
Visual acuity, dense and relative scotoma size and location, and PRL location were compared; and relationships between anatomic and functional changes were observed. Decreases in scotoma size and improvement in PRL location and ability usually corresponded with improved visual acuity. Preoperative scotoma and PRL location guided retinotomy site selection.


CONCLUSIONS
Scanning laser ophthalmoscope macular perimetry and PRL testing may be useful adjuncts in the visual assessment of submacular surgery and may advance under-standing of the effects of submacular surgery on visual function. In addition, this testing may be used to plan location of surgical interventions for macular diseases.
Sabates
N R
NR
Department of Ophthalmology, University of Missouri-Kansas City School of Medicine, Eye Foundation of Kansas, City 64108, USA.
Crane
W G
WG
Sabates
F N
FN
Schuchard
R A
RA
Fletcher
D C
DC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D015821:Eye Infections, Fungal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006660:Histoplasmosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007834:Lasers; D008266:Macula Lutea / Q000503:physiopathology / Q000601:surgery*; D008268:Macular Degeneration / Q000150:complications; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019721:Ophthalmoscopes; D012166:Retinal Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012607:Scotoma / Q000175:diagnosis* / Q000503:physiopathology; D014792:Visual Acuity; D058609:Visual Field Tests / Q000379:methods*