Visual outcome after intravitreal ranibizumab for wet age-related macular degeneration: a comparison between best-corrected visual acuity and microperimetry.
OBJECTIVE
The purpose of this study was to compare the observed change in best-corrected visual acuity (BCVA) with the change in central retinal sensitivity pretreatment and 1 month after 3 consecutive treatments with ranibizumab in patients with wet age-related macular degeneration.


METHODS
Ten consecutive patients with untreated age-related macular degeneration underwent microperimetric and BCVA assessment before and 1 month after 3 consecutive treatments with ranibizumab. Best-corrected visual acuity was assessed at 2 m by using the Early Treatment Diabetic Retinopathy Study chart. Threshold microperimetry was performed using a Goldman III stimulus to 45 points over the central 12 degrees of the macula. Significant visual improvement after treatment was defined as a change in BCVA >/=10 letters or, on microperimetry, a change in mean retinal sensitivity > or = 2 dB.


RESULTS
One month after treatment, the median change in BCVA was +6 letters (range, -15 to +12), and the mean change in the mean retinal sensitivity was +2.86 dB (standard deviation, 1.55 dB). One patient recorded a significant improvement in BCVA compared with 8 patients who recorded a significant improvement in mean retinal sensitivity (P = 0.016).


CONCLUSIONS
Compared with microperimetry, BCVA seems to significantly underestimate the change in visual function experienced by patients treated with ranibizumab.
Squirrell
David M
DM
Department of Ophthalmology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. jmbush@doctors.org.uk
Mawer
Nick P
NP
Mody
Christopher H
CH
Brand
Christopher S
CS
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D006801:Humans; D007267:Injections; D000069579:Ranibizumab; D012160:Retina / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D014822:Vitreous Body; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab