What you see is not always what you get in atrophic macular disease.
OBJECTIVE
To show that the area of atrophy seen on ophthalmoscopy may not correspond with the area of scotoma in some macular diseases.


METHODS
Three cases are presented, one with geographic atrophy (GA) from age-related macular degeneration, one with Stargardt disease, and one with a macular dystrophy. Nidek MP-1 microperimetry was performed and the correspondence of the dense scotoma to the visible atrophy is reported.


RESULTS
In the GA patient, the dense scotoma corresponds with the atrophy. In the patient with Stargardt disease, the dense scotoma is larger than the area of visible atrophy. In the patient with a macular dystrophy, the dense scotoma is smaller than the area of visible atrophy.


CONCLUSIONS
In GA from age-related macular degeneration, the dense scotoma generally corresponds with the atrophy, so that measurement of the enlargement rate of the atrophy is a direct measure of enlargement of the scotoma. This may not be true of other macular diseases.
From the Richard E. Hoover Services for Low Vision and Blindness and the Department of Ophthalmology, Greater Baltimore Medical Center, Maryland.
Janet S
JS
Sunness