SCANNING LASER OPHTHALMOSCOPE MACULAR PERIMETRY IN THE EVALUATION OF SUBMACULAR SURGERY

Purpose: Submacular surgery for choroidal neovascularization (CNV) is under investigation in the treatment of age-related macular degenerati on (AMD) and the presumed ocular histoplasmosis syndrome. Four case st udies are presented to demonstrate scanning laser ophthalmoscope (SLO) testing in the pre- and postsurgical evaluation of visual function in patients with subfoveal CNV secondary to AMD, presumed ocular histopl asmosis syndrome, and submacular hemorrhage secondary to AMD. Methods: Patients underwent a visual assessment pre- and 6 months postoperativ ely, consisting of low vision visual acuity measurement, SLO macular p erimetry of dense and relative scotomas, and analysis of the preferred retinal locus for fixation (PRL) location and ability. Results: Visua l acuity, dense and relative scotoma size and location, and PRL locati on were compared; and relationships between anatomic and functional ch anges were observed. Decreases in scotoma size and improvement in PRL location and ability usually corresponded with improved visual acuity, Preoperative scotoma and PRL location guided retinotomy site selectio n. Conclusion: Scanning laser ophthalmoscope macular perimetry and PRL testing may be useful adjuncts in the visual assessment of submacular surgery and may advance understanding of the effects of submacular su rgery on visual function, In addition, this testing may be used to pla n location of surgical interventions for macular diseases.