Universität zu Köln

Hoerster, Robert, Muether, Philipp S., Hermann, Manuel M., Koch, Konrad, Kirchhof, Bernd and Fauser, Sascha (2011). Subjective and functional deterioration in recurrences of neovascular AMD are often preceded by morphologic changes in optic coherence tomography. Br. J. Ophthalmol., 95 (10). S. 1424 - 1427. LONDON: B M J PUBLISHING GROUP. ISSN 0007-1161

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Abstract

Background Different tests were applied to test the sensitivity of patient self-control; Amsler grid and visual acuity (VA) assessment, as well as fundus examinations to reveal recurrent choroidal neovascularisation (CNV) activity in age-related macular degeneration as detected by spectral domain optical coherence tomography (SD-OCT) in monthly controls. Methods A prospective interventional case series of patients with exudative age-related macular degeneration was examined, which received ranibizumab injections until complete resolution of fluid in SD-OCT. Analysis of changes in subjective perception, Amsler grid, early treatment diabetic retinopathy study (ETDRS) VA, Radner reading VA and fundus examination was conducted in the case of OCT-confirmed CNV recurrences. Results Out of 40 morphological recurrences determined by SD-OCT, six (15%) were noticed by subjective patient perception. Amsler grid testing revealed deterioration in 12 cases (30%); 11 recurrences (28%) were accompanied by loss of >= 5 letters in ETDRS VA and/or >= 1 line in Radner VA; fundus examination showed signs of novel CNV activity in 10 out of 40 recurrences (25%). The combined sensitivity of all diagnostic methods compared to SD-OCT for recurrence detection was 67.5% (27 out of 40 recurrences). Conclusion Subjective patient perception, Amsler grid, VA as well as fundus examination lead to pronounced underestimations of CNV recurrences. Morphologic recurrences can be detected prior to functional deterioration. As any delay of treatment can result in irreversible vision loss, attempts should be made to provide monthly OCT controls to detect recurrences as early as possible.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoerster, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Muether, Philipp S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermann, Manuel M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Konrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirchhof, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Fauser, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-488337
DOI:	10.1136/bjo.2010.201129
Journal or Publication Title:	Br. J. Ophthalmol.
Volume:	95
Number:	10
Page Range:	S. 1424 - 1427
Date:	2011
Publisher:	B M J PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	0007-1161
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MACULAR DEGENERATION; INTRAVITREAL RANIBIZUMAB; VISUAL-ACUITY; BEVACIZUMAB; MACULOPATHY; PREVALENCE Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48833