Macular Degeneration: Springer A

Goldstein M, Loewenstein A, Barak A, Pollack A, Bukelman A, Katz H, Springer A, Schachat AP, Bressler NM, Bressler SB, Cooney MJ, Alster Y, Rafaeli O, Malach R, Anonymous00107. · Department of Ophthalmology, Tel-Aviv Medical Center, Israel. · Retina. · Pubmed #15805906 No free full text.

Abstract: PURPOSE: To compare the preferential hyperacuity perimeter (PHP) with an Amsler grid in detection of age-related macular degeneration (AMD). METHODS: Patients underwent refraction, visual acuity examination, PHP, Amsler grid examination, and macular photography. RESULTS: One hundred fifty patients participated in the trial. Of 19 eyes with neovascular AMD, 19 (100%) were positive on the PHP, and 10 (53%), on the Amsler grid. Of 27 eyes with geographic atrophy, 26 (96%) were positive on the PHP, and 12 (44%), on the Amsler grid. Of 20 eyes with intermediate AMD, 14 (70%) were positive on the PHP, and 4 (20%), on the Amsler grid. Of 51 eyes with early AMD, 21 (41%) were positive on the PHP, and 4 (8%), on the Amsler grid. Of 33 eyes with no AMD, 6 (18%) were positive on the PHP, and none, on the Amsler grid. Thus, 80 (68%) of 117 patients with AMD had a positive PHP, while 30 (26%) had positive results of Amsler grid examination (P < 0.001, McNemar test). CONCLUSION: The PHP had greater sensitivity, although with a relatively high rate of false-positive results for healthy individuals, than the Amsler grid in detecting AMD-related lesions.

Landa G, Springer A, Bukelman A, Pollack A. · Department of Ophthalmology, Kaplan Medical Center, Rehovot 76100, Israel. · Eur J Ophthalmol. · Pubmed #17671939 No free full text.

Abstract: PURPOSE: To assess the contribution of indocyanine green angiography (ICGA) to fluorescein angiography (FA) in evaluating fellow drusen eyes of patients with wet age-related macular degeneration (AMD) in the other eye. METHODS: The records of paired FA and ICGA of patients with dry AMD in one eye and wet AMD in the other eye were retrospectively reviewed. Based on color fundus photographs, drusen were graded to low, moderate, or high grade of severity on FA. The FA and ICGA findings were compared. RESULTS: Fifty-two pairs of eyes were included. Fluorescein angiography showed drusen of low severity in 11 (21.2%) eyes, of moderate severity in 31 (59.6%), and of high severity in 10 (19.2%). Leakage on both FA and ICGA was not demonstrated in any case of drusen of low or moderate severity. Only in 2 out of 10 eyes from the high severity group, 3.8% of the eyes of the whole study population, did ICGA reveal occult choroidal neovascularization (CNV) that was not observed on FA. CONCLUSIONS: In selected eyes with drusen of high grade severity, ICGA may detect occult CNV, unrecognized clinically or by FA. ICGA had a small contribution to the diagnosis of occult CNV in fellow drusen eyes with any degree of severity.