title: Preferential hyperacuity perimeter in assessing responsiveness to ranibizumab therapy for exudative age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the ability of the preferential hyperacuity perimeter test to assess responsiveness to ranibizumab therapy for exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Fourteen consecutive patients with newly diagnosed choroidal neovascularisation underwent a preferential hyperacuity perimeter metamorphopsia test (main outcome measures) 1 h before (baseline) and 1 h, 1 day, 1 week and 1 month after one intravitreal injection of ranibizumab (0.05 ml/0.5 mg). Best corrected visual acuity (BCVA) and several spectral domain optical coherence tomography (OCT) parameters (secondary outcome measures) were compared with the metamorphopsia test.
  
  
  RESULTS
  Fourteen eyes (14 patients, 78% women, mean age 83 ± 6.2 years) were included in the analysis. The mean preferential hyperacuity perimeter metamorphopsia test score improved significantly from 20.4 ± 35 at baseline to 9.2 ± 23 after the single ranibizumab injection (p < 0.05). The mean reduction in central macular thickness, maximal retinal thickness at the fovea, maximal height of subretinal fluid, maximal diameter of the largest retinal cyst and maximal height of pigment epithelial detachment, as evaluated by spectral domain OCT, closely reflected the functional improvements as evaluated by preferential hyperacuity perimeter, showing a significant correlation with metamorphopsia changes (Spearman correlation 0.9, p < 0.05). Mean BCVA improved significantly from 20/80 to 20/60 (p < 0.05). A significant correlation was also found between the mean BCVA changes and the mean metamorphopsia changes (Spearman correlation 0.97, p < 0.05). The correlation coefficient between OCT measurements and preferential hyperacuity perimeter score within subjects was 0.51 (p < 0.05).
  
  
  CONCLUSIONS
  The improvement in metamorphopsia test score after intravitreal ranibizumab injection, which correlated closely with improvement in several OCT parameters, suggests that the preferential hyperacuity perimeter test may be used to monitor the response to anti-vascular endothelial growth factor (VEGF) treatment in patients with exudative AMD.
authors.affiliation: Department of Ophthalmology, University of Paris XII, Centre Hospitalier Intercommunal de Creteil, Creteil, France. giuseppe.querques@hotmail.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Elya
authors.initials: E
authors.lastname: Berboucha
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leveziel
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pece
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D004305:Dose-Response Relationship, Drug; D004867:Equipment Design; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010865:Pilot Projects; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology; D058609:Visual Field Tests / Q000295:instrumentation
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab