Purpose: To investigate the association between visual acuity and fixation in patients with neovascular age-related macular degeneration (nAMD) with poor visual acuity during the treatment maintenance phase.
Patients and methods: Sixty-nine eyes from 69 patients with nAMD in the treatment maintenance phase who had corrected visual acuity of 0.5 or less and had measurable fixation tests using a microperimeter-3 (MP-3) were included. The visual fixation of the affected eye (fixation stability, fixation location, distance between the central fovea and fixation point) and the association with the visual acuity of the affected eye was evaluated. Stratified analyses were also performed on visual fixation on the basis of the decimal visual acuity of the affected eye. Lastly, factors associated with visual acuity in the affected eye were evaluated using multivariate analyses.
Results: The logarithmic minimum angle of resolution (logMAR) of the mean visual acuity in the affected eye worsened with worse fixation stability, fixation location, and distance between the central fovea and fixation point in the affected eye, showing a significant association (p<0.001). In the stratified analyses, the degree of fixation stability in the affected eye was significantly different (p=0.015); however, the proportion of the area of fixation containing the central fovea did not significantly differ (p=0.404) in the comparison between groups on the basis of the decimal visual acuity of the affected eye. In the multivariate analyses, logMAR values of the visual acuity of the affected eye were significantly associated with the fixation stability of the affected eye (p=0.015), and the distance between the central fovea and fixation points in the affected eye (p=0.001).
Conclusion: In patients with nAMD with poor visual acuity during the maintenance phase of treatment, the fixation stability of the affected eye and the distance between the central fovea and fixation points worsened with worsening degree of poor visual acuity in the affected eye.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 465-471, 2020.