Vision before and after scharioth macular lens implantation in patients with AMD: an electrophysiological study

Abstract Background For patients with age-related macular degeneration (AMD), a special intraocular lens implantation partially compensates for the loss in the central part of the visual field. For six months, we evaluated changes in neurophysiological parameters in patients implanted with a “Scharioth macula lens” (SML; a center near high add + 10 D and peripheral plano carrier bifocal lens designed to be located between the iris and an artificial lens). Methods Fourteen patients (5 M, 9 F, 63–87 years) with dry AMD were examined prior to and at 3 days after, as well as 1, 2, and 6 months after, implantation using pattern-reversal, motion-onset, and cognitive evoked potentials, psychophysical tests evaluating distant and near visual acuity, and contrast sensitivity. Results Near visual acuity without an external aid was significantly better six months after implantation than before implantation (Jaeger table median (lower; upper quartile): 4 (1; 6) vs. 15 (13; 17)). Distant visual acuity was significantly altered between the pre- (0.7 (0.5; 0.8) logMAR) and last postimplantation visits (0.8 (0.7; 0.8) logMAR), which matched prolongation of the P100 peak time (147 (135; 151) ms vs. 161 (141; 166) ms) of 15 arc min pattern-reversal VEPs and N2 peak time (191.5 (186.5; 214.5) ms vs. 205 (187; 218) ms) of peripheral motion-onset VEPs. Conclusion SML implantation significantly improved near vision. We also observed a slight but significant decrease in distant and peripheral vision. The most efficient electrophysiological approach to test patients with SML was the peripheral motion-onset stimulation, which evoked repeatable and readable VEPs.

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High-addition segmented refractive bifocal intraocular lens in inactive age-related macular degeneration: A multicenter pilot study

PLoS ONE ◽

10.1371/journal.pone.0256985 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256985

Author(s):

Gerd U. Auffarth ◽

Josef Reiter ◽

Martin Leitritz ◽

Karl-Ulrich Bartz-Schmidt ◽

Fabian Höhn ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Intraocular Lens ◽

Intraoperative Complications ◽

Age Related Macular Degeneration ◽

Open Label ◽

Age Related ◽

Near Visual Acuity ◽

Reading Distance ◽

Bifocal Intraocular Lens

This multicenter, open-label study aimed to determine the safety and functional outcome of a high-addition segmented refractive bifocal intraocular lens (IOL) in late inactive age-related macular degeneration (AMD). Twenty eyes of 20 patients were enrolled and followed until 12 months after the intervention. Patients underwent cataract surgery with implantation of a LS-313 MF80 segmented refractive bifocal intraocular lens with a near addition of +8.0 D (Teleon Surgical Vertriebs GmbH, Berlin, Germany). The main outcome measures were distance corrected near visual acuity (DCNVA) and safety as determined by intra- and post-operative complications. Secondary outcomes included distance corrected visual acuity (CDVA), uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), the need for magnification to read newspaper, preferred reading distance, speed and performance (logRAD), as well as patient satisfaction. Mean DCNVA improved from 0.95 (±0.19) to 0.74 (±0.35) logMAR, until 6 months after surgery, P<0.05. CDVA improved from 0.70 (±0.23) to 0.59 (±0.30) logMAR, UDVA from 0.94 (±0.25) to 0.69 (±0.34) logMAR, UNVA from 1.08 (±0.19) to 0.87 (±0.43) logMAR. The mean need for magnification decreased from 2.9- to 2.3-fold, preferred reading distance from 23 to 20 cm. No intraoperative complications occurred during any of the surgeries. One patient lost > 2 lines of CDVA between 6 and 12 months, in another case, the study IOL was exchanged for a monofocal one due to dysphotopsia and decreased CDVA. Implantation of a segmented refractive bifocal IOL with +8.0 D addition improves near and distance vision in patients with late AMD and has a satisfactory safety profile.

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Electrophysiological study after ranibizumab in choroidal neovascularizat

10.36811/irjo.2021.110009 ◽

2021 ◽

pp. 3-13

Author(s):

Mona Abdelkader ◽

Ayman Fawzy ◽

Wael El-doskey

Keyword(s):

Visual Acuity ◽

Intravitreal Injection ◽

Choroidal Neovascularization ◽

Electrophysiological Study ◽

Multifocal Electroretinogram ◽

Pattern Electroretinogram ◽

Retinal Toxicity ◽

Age Related Macular Degeneration ◽

Age Related ◽

Subfoveal Choroidal Neovascularization

Purpose: To study the effects of intra-vitreal injection of ranibizumab on pattern electroretinogram (PERG) and multifocal electroretinogram(MF-ERG) parameters in choroidal neovascularization and to test the retinal toxicity of ranibizumab. Method: Fifty eyes of 50 patients with subfoveal choroidal neovascularization were included in the study. Thirty (30) eyes had neovascular age related macular degeneration (nAMD) and 20 eyes had myopic choroidal neovascularization. Ranibizumab was injected intravitreal monthly for3 months. Optical Coherence Tomography Angiography (OCT) was performed at the initial and final visits. Visual acuity, Pattern and multifocal electroretinography (PERG, MFERG) were performed before and at 1,2,3,6 months after intravitreal injection. Results: There was no clinical significant reduction of parameters of either MFERG or PERG after intravitreal injection of ranibizumab. There was significant increase in visual acuity, decrease in central macular thickness ,decrease in total macular volume and improvement in the parameters of both PERG and MFERG after intravitreal injection. Conclusion: Intravitreal injection of ranibizumab is effective in treatment CNV and safe. It has no retinal toxicity since no reduction in PERG& MFERG parameters. Keywords: AMD; Ranibizumab; PERG; MFERG

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Four Years of Observation to Evaluate Autonomy and Quality of Life after Implantation of a High-Add Intraocular Lens in Age-Related Macular Degeneration Patients

Case Reports in Ophthalmology ◽

10.1159/000508914 ◽

2020 ◽

Vol 11 (2) ◽

pp. 448-456

Author(s):

Andreas F. Borkenstein ◽

Eva-Maria Borkenstein

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Low Vision ◽

Age Related Macular Degeneration ◽

Age Related ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity ◽

Dry Amd

Visual impairment resulting from advanced dry age-related macular degeneration (AMD) limits the ability to perform activities required for independent living and adversely affects quality of life. We aimed to determine changes in these parameters in patients with AMD-related geographic atrophy who underwent magnifying cataract surgery (MAGS) using a foldable, bifocal high-add intraocular lens (IOL). The high-add IOL (LENTIS® MAX LS-313 MF 80, Oculentis) was implanted in the better seeing or dominant eye of eligible patients with clinically significant cataract, best corrected distance visual acuity 1.3–0.5 logMAR (20/400–20/63), best corrected near visual acuity >0.8 logMAR (20/125), and stable advanced dry AMD. Self-reported feasibility of performing routine activities and change in quality of life were the main outcome measures. Eleven of 15 operated patients had complete follow-up to 48 months. There were no significant intraoperative or postoperative complications. AMD converted from dry to wet in 2 patients. All patients reported functional gains in the first 3–6 months after surgery, and 10/11 patients reported improved quality of life. From baseline to 48 months, functional performance remained improved in all patients, and quality of life remained improved in the 9 patients with stable AMD. Best corrected distance visual acuity and uncorrected near visual acuity improved in all cases after surgery. Conclusion: Implantation of the high-add IOL was safe and resulted in durable functional and quality of life benefits. To our knowledge, our report describes the longest prospective follow-up (4 years) of a series of patients undergoing MAGS for rehabilitation of low vision related to advanced AMD. Data are needed from larger cohorts, but our experience supports giving consideration to MAGS in appropriately selected patients with low vision related to advanced dry AMD. We encourage further industry development of this technology and additional clinical research to collect more outcomes data to determine its potential to help patients maintain highly valued autonomy and quality of life.

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Changes in visual acuity in patients with dry form of age-related macular degeneration after low-energy light therapy and medication

Oftalmologicheskii Zhurnal ◽

10.31288/oftalmolzh201652228 ◽

2016 ◽

Vol 63 (5) ◽

pp. 22-28

Author(s):

A. Sergienko ◽

◽

N. Dzyuba ◽

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Light Therapy ◽

Low Energy ◽

Age Related Macular Degeneration ◽

Age Related

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Genetic biomarkers in the VEGF pathway predicting response to anti-VEGF therapy in age-related macular degeneration

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000273 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000273

Author(s):

Irina Balikova ◽

Laurence Postelmans ◽

Brigitte Pasteels ◽

Pascale Coquelet ◽

Janet Catherine ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Treatment Response ◽

Multiple Testing ◽

Age Related Macular Degeneration ◽

Patient Specific ◽

Multiple Testing Correction ◽

Anti Vegf ◽

Age Related ◽

Vegf Pathway

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.

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