Preferential Hyperacuity Perimeter in assessing responsiveness to ranibizumab therapy for exudative age-related macular degeneration

Giuseppe Querques (1) , Elya Berboucha (1) , Nicolas Leveziel (1) , Alfredo Pece (2) , Eric H Souied (1)

1 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
2 Retina 3000 Fundation

Background: To investigate the ability of Preferential Hyperacuity Perimeter in assessing responsiveness to ranibizumab therapy for exudative age-related macular degeneration (AMD). Methods: Fourteen consecutive patients with newly diagnosed choroidal neovasularization underwent Preferential Hyperacuity Perimeter metamorphopsia test (main outcome measures), 1 hour before (baseline) and 1 hour, 1 day, 1 week and 1 month after one intravitreal injection of ranibizumab (0.05 ml/0.5mg). Best-corrected visual acuity (BCVA), and several spectral domain optical coherence tomography (OCT) parameters (secondary outcome measures) were compared to metamorphopsia test. Results: Fourteen eyes (14 patients, 78% women, mean age 83±6.2 years) were included in the analysis. Mean Preferential Hyperacuity Perimeter metamorphopsia test score significantly improved from 20.4 ±35 to 9.2 ±23, after the single ranibizumab injection (p<0.05). 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, well reflected the functional improvements as evaluated by Preferential Hyperacuity Perimeter, showing a significant correlation with metamorphopsia changes (0.9 Spearman correlation, p<0.05). Mean BCVA also significantly improved 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 (0.97 Spearman correlation, p<0.05). The correlation coefficient between OCT measurements and PHP score within subjects was 0.51 (p<0.05) Conclusion: The improvement in metamorphopsia test score after intravitreal ranibizumab injection, which well correlates with improvement in several OCT parameters, suggests that Preferential Hyperacuity Perimeter may be used to monitor response to anti-VEGF treatment in patients with exudative AMD.

Mots clés: Retina; Macula; Neovascularisation; Degeneration; Diagnostic tests/Investigation

Giuseppe Querques, Elya Berboucha, Nicolas Leveziel, Alfredo Pece, Eric H Souied. Preferential Hyperacuity Perimeter in assessing responsiveness to ranibizumab therapy for exudative age-related macular degeneration. British Journal of Ophthalmology, 2010, 95 (7), pp.986. ⟨10.1136/bjo.2010.190942⟩. ⟨hal-00602301⟩