Retinotopic cortical mapping in objective functional monitoring of macular therapy.

Autor:	Ritter M; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Hummer A; MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Pawloff M; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Ledolter AA; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Linhardt D; MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Woletz M; MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Deak GG; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Sacu S; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Ristl R; Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria., Ramazanova D; Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria., Holder GE; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; UCL Institute of Ophthalmology, London, UK., Windischberger C; MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Schmidt-Erfurth UM; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria ursula.schmidt-erfurth@meduniwien.ac.at.
Jazyk:	angličtina
Zdroj:	The British journal of ophthalmology [Br J Ophthalmol] 2024 May 29. Date of Electronic Publication: 2024 May 29.
DOI:	10.1136/bjo-2021-320723
Abstrakt:	Background/aims: To determine the suitability of functional MRI (fMRI) as an objective measure of macular function following therapeutic intervention; conventional psychophysical measures rely heavily on patient compliance. Methods: Twenty patients with neovascular age-related macular degeneration (nAMD) were studied with high-resolution fMRI, visual acuity, reading accuracy and speed, contrast sensitivity (CS) and microperimetry (MP) before and after 3 monthly intravitreal injections of ranibizumab. Population-receptive field retinotopic maps calculated from fMRI data were compared with psychophysical measures and optical coherence tomography. Results: Best-corrected visual acuity (BCVA) responders (≥5 letters) showed an increase of 29.5% in activated brain area, while non-responders showed a decrease of 0.8%. Radial histograms over eccentricity allowed quantification of the absolute number of significant voxels and thus differences before and after treatment. Responders showed increases in foveal (α<0.5°) activation, while non-responders did not. Absence of intraretinal fluid and preservation of outer retinal layers was associated with higher numbers of active V1 voxels and better BCVA. Higher voxel numbers were associated with improved reading performance and, less marked, with BCVA, CS and MP. Conclusion: The data show that retinotopic mapping using fMRI can successfully be applied objectively to evaluate the therapeutic response in nAMD patients treated with anti-vascular endothelial growth factor therapy. This demonstrates the ability of retinotopic mapping to provide an objective assessment of functional recovery at a cortical level; the technique can therefore be applied, in other degenerative macular diseases, to the assessment of potential therapeutic interventions such as gene therapy or cell replacement therapy. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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