The influence of cortical, nuclear, subcortical posterior, and mixed cataract on the results of microperimetry.

PURPOSE: Microperimetry is a useful instrument for evaluating sensitivity threshold due to retinal pathologies. The aim of the study is to assess the impact of different forms of cataract on microperimetry results. METHODS: In a prospective design, patients were recruited for cataract surgery at the Department of Ophthalmology, Medical University of Vienna. Exclusion criteria were any other ophthalmic disease except cataract, that is, macular pathology. Using the Lens Opacities Classification System III classification, patients were classified into four groups: nuclear, cortical, subcapsular posterior, and mixed cataract. Then patients underwent microperimetry: results were analyzed for magnitude of retinal sensitivity loss and correlated to the forms and density of the cataract. RESULTS: Mean density of cataract was LOCS 3.2-3.5 in the four groups. Differences were not statistically significant. The best-corrected visual acuity (BCVA) was LogMAR 0.5 ± 0.13 in nuclear, LogMAR 0.49 ± 0.21 in cortical, and LogMAR 0.58 ± 0.12 in mixed cataract patients, and significantly worse in patients with subcapsular posterior cataract (LogMAR 0.64 ± 0.12). Microperimetry shows a mean sensitivity of 11.4-12.6 dB without significant group differences. The BCVA is correlated with microperimetry in patients with nuclear and cortical cataract. Density of cataract is highly correlated with microperimetry results in all groups. CONCLUSION: The present study shows a good correlation of microperimetry results with the BCVA of patients with nuclear and cortical cataract. In patients with subcapsular posterior cataract, microperimetry results were better than estimated by BCVA. Density of cataract is highly correlated with macular sensitivity. A reduction of 1 dB in microperimetry per 1 posterior capsule opacification score increase can be estimated for these patients.

Visual performance 3 years after successful macular hole surgery.

BACKGROUND/AIMS: To evaluate the visual performance of patients with successful macular hole surgery with a minimum follow-up of 3 years. Results were compared with the performance of the healthy fellow eyes. METHODS: 15 patients were studied. The healthy fellow eyes of the patients (13 eyes) served as a control group. Age, gender and best-corrected logMAR visual acuity were recorded. Reading acuity (in log reading acuity determination (RAD), reading equivalent of logMAR) and speed were tested monocularly. Scotoma size was measured with SLO perimetry, and hole closure was confirmed with an OCT scan. RESULTS: The mean distance visual acuity of the operated eyes (logMAR 0.32 (SD 0.21)) was significantly lower than that of the healthy fellow eyes (logMAR 0.05 (0.17)), but significantly higher than preoperatively (logMAR 0.71 (0.32)). The mean reading acuity was logRAD 0.47 (0.25) for the operated eyes ( = 77.9% of logMAR), and statistically significantly higher (logRAD 0.16 (0.16)) for the fellow eyes ( = 89.4% of logMAR). The mean maximum reading speeds were comparable for the operated eyes (168.3 (23.1) words per minute (wpm)) and the fellow eyes (178.7 (26.1) wpm) (p = 0.3). Within logRAD 1.3 and 0.5, the mean reading speeds of the two groups were comparable, but critical print size (CPS) for the operated group (logRAD 0.7 (0.2)) was significantly worse than those for the fellow eyes (logRAD 0.4 (0.2)). The SLO analysis showed absence of absolute scotoma in 12 eyes. CONCLUSION: Distance and reading acuity showed remaining deficits compared with the healthy fellow eyes; however, mean maximum reading speeds of the operated eyes achieved results comparable with healthy eyes. The results show a long-term benefit in the visual function of eyes with closed macular holes.

Interexaminer and intraexaminer reliability of the microperimeter MP-1.

PURPOSE: To evaluate the interexaminer and intraexaminer reliability of macular microperimetry using the microperimeter MP-1. METHODS PARTICIPANTS: Fifteen healthy volunteers younger than 40 years of age (Group 1), 15 healthy subjects over 60 years (Group 2), and five patients with age-related macular degeneration (Group 3). OBSERVATION PROCEDURE: Two examiners (E1 and E2) measured, in random order, interexaminer (E2-E1a) reliability. Another examination was undergone by one of the examiners a week later to evaluate the intraexaminer (E1b-E1a) reliability. MAIN OUTCOME MEASURES: Macular sensitivity (mean threshold (decibel)) and stability of fixation were determined using MP1 microperimetry. Agreement was analysed by means of Bland-Altman plots and by the determination of the intraclass correlation coefficient.ResultsThe interexaminer (E2-E1a) and the intraexaminer (E1b-E1a) differences in the mean threshold values were not statistically significant (P=0.850, 95% confidence Interval (CI)=-0.265 to 0.319; P=0.246, 95% CI=-0.099 to 0.375, respectively). Limits of agreement and intraclass correlation coefficients also showed good agreement in each group. CONCLUSIONS: A good reliability was found for the mean threshold values in all the three groups, indicating examiner-independent measurements.

Influence of sex, visual acuity, and systemic disease on delayed presentation for cataract surgery in Austria.

PURPOSE: To determine the influence of sex, age, preoperative visual acuity, and systemic disease on the delay in presentation for first-eye cataract surgery. SETTING: University Eye Clinic, Vienna, Austria. METHODS: This retrospective study comprised 200 consecutive patients with age-related cataract who were referred to the Ophthalmology Department of the University of Vienna and who had cataract surgery in the first eye. Patients with additional intraocular procedures or with other ocular comorbidity were excluded. Age, sex, preoperative best corrected Snellen visual acuity in both eyes, ocular and systemic comorbidity, and the duration of preoperative visual deterioration were recorded. The patients were divided into groups depending on systemic comorbidity. The severity of disease was categorized as no therapy necessary or nonexistent, nonsevere, or severe. RESULTS: The mean age of women and men was 74.9 years and 70.7 years, respectively, and the mean preoperative visual acuity, 0.31 and 0.24. The duration of preoperative visual deterioration was 8.6 months and 12.2 months, respectively. All differences were statistically significant (P <.05). The visual acuity in the better eye was not significantly different between men and women. Neither the presence nor the type of systemic disease influenced preoperative visual acuity or the duration of preoperative visual deterioration. CONCLUSIONS: Although the visual acuity in the better eye was not different between men and women, men had cataract surgery after a longer duration of visual deterioration and with a worse visual acuity. More public information about cataract surgery is required to keep visual deterioration secondary to cataract to a minimum.