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Computer-based visual evaluation as a screening tool after intravitreal injections of vascular endothelial growth
Carsten H Meyer1, Deborah J Lapolice
1Department of Ophthalmology, Philipps-University, Marburg, Germany. meyer_eye@yahoo.com
Purpose:
To evaluate the visual acuity (VA) of patients following intravitreal (IVT) injections.
Methods:
15 patients received 3 anti-vascular-endothelial-growth-factor (VEGF) injections on a monthly basis. Prior to each injection as well as 2 months after, the patients received a standardized examination including Snellen VA and optical coherence tomography (OCT). During this time the patients were trained to evaluate their central VA by 3 computer-based tests: (a) VA was examined by the patient on a computer-based vision chart and (b) subjectively categorized as 'same', 'worse' or 'better'; (c) the edge of metamorphopsia was outlined on a digital Amsler grid.
Results:
VA improved during the 3 injections by >or=2 lines (13/15). The assessment demonstrated subjective improvement (13/15), i.e. a gain of 2 or more lines or decreased central metamorphopsia (12/15). Reevaluation 2 months later demonstrated a decline of >or=1 Snellen line or increased retinal thickness on OCT (8/15), and a decline of >or=1 line or an enlarged metamorphopsia in the computer-based tests (6/15).
Conclusion:
Our pilot study demonstrated a good correlation between the professional examination and the computer-based assessment. Selected patients can define their visual impairment. A web-based VA evaluation may help to screen patients after IVT injections on a regular basis at home.
