Abstract

The identification of different fixation, acuity and scotoma patterns is important because it may influence decision making in laser treatment. By the same token it can assist in the implementation of low vision rehabilitation strategies for ARMD. Although some detailed studies of fixation and scotoma patterns in ARMD have been published using the scanning laser ophthalmoscope, they basically reported the findings on some cases in detail, exposing the technology involved, and pointing out the fundamental advantage of using the scanning laser ophthalmoscope. Namely, the SLO permits an unambiguous localization of stimuli and a continuous observation under approximate natural conditions. Detailed off-line analysis of data involving the correction for fixation shifts and reaction time was performed in these studies. We adapted, essentially simplified microperimetric techniques for a clinical research setting: a maximum of about twenty minutes can be devoted to each eye exam, probably the limit of what a patient can endure. During each session, fixation, scotoma distribution and visual acuity were assessed using the scanning laser ophthalmoscope. This pilot study attempts to find out on a somewhat larger database of patients whether consistent patterns of fixation, scotoma and acuity exist in macular disease. Primary goals are the building of a preliminary classification system to be used in further analysis of functional deficits in macular disease and figuring out how the knowledge gained could possibly influence treatment strategies. Treatment modalities are essentially limited to two possibilities: low vision rehabilitation - after the anatomical and functional damage has occured - and either preventive or therapeutic application of lasers. Pre-treatment microperimetry information may help decide whether to treat and how to treat, post-treatment microperimetry information could serve as a follow-up to see whether treatment was successful or not.

© 1995 Optical Society of America