PMID- 21768186
OWN - NLM
STAT- MEDLINE
DCOM- 20111109
LR  - 20151119
IS  - 1468-2079 (Electronic)
IS  - 0007-1161 (Linking)
VI  - 95
IP  - 10
DP  - 2011 Oct
TI  - Subjective and functional deterioration in recurrences of neovascular AMD are 
      often preceded by morphologic changes in optic coherence tomography.
PG  - 1424-6
LID - 10.1136/bjo.2010.201129 [doi]
AB  - 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.
FAU - Hoerster, Robert
AU  - Hoerster R
AD  - Centre of Ophthalmology, University of Cologne, Cologne, Germany.
FAU - Muether, Philipp S
AU  - Muether PS
FAU - Hermann, Manuel M
AU  - Hermann MM
FAU - Koch, Konrad
AU  - Koch K
FAU - Kirchhof, Bernd
AU  - Kirchhof B
FAU - Fauser, Sascha
AU  - Fauser S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110718
PL  - England
TA  - Br J Ophthalmol
JT  - The British journal of ophthalmology
JID - 0421041
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - ZL1R02VT79 (Ranibizumab)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiogenesis Inhibitors/administration & dosage
MH  - Antibodies, Monoclonal/administration & dosage
MH  - Antibodies, Monoclonal, Humanized
MH  - Contrast Sensitivity/*physiology
MH  - Female
MH  - Fluorescein Angiography
MH  - Humans
MH  - Intravitreal Injections
MH  - Male
MH  - Prospective Studies
MH  - Ranibizumab
MH  - Recurrence
MH  - Sensitivity and Specificity
MH  - *Tomography, Optical Coherence
MH  - Visual Acuity/*physiology
MH  - Wet Macular Degeneration/*diagnosis/drug therapy/*physiopathology
EDAT- 2011/07/20 06:00
MHDA- 2011/11/10 06:00
CRDT- 2011/07/20 06:00
PHST- 2011/07/20 06:00 [entrez]
PHST- 2011/07/20 06:00 [pubmed]
PHST- 2011/11/10 06:00 [medline]
AID - bjo.2010.201129 [pii]
AID - 10.1136/bjo.2010.201129 [doi]
PST - ppublish
SO  - Br J Ophthalmol. 2011 Oct;95(10):1424-6. doi: 10.1136/bjo.2010.201129. Epub 2011 
      Jul 18.