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Rossi S., Testa F., Di Iorio V., Orrico A., Dell’Aversana Orabona G., Di Perna L., Attanasio M., Della Corte M., Sbordone S., Bifani M.
Dipartimento di Oftalmologia della Seconda Università di Napoli, Napoli, Italia
Aim. Stargardt’s disease is the most common form of juvenile macular degeneration with a prevalence of 1:8000-1:10000. The purpose of this study was to demonstrate the validity of microperimetry testing, in the diagnosis, follow up and prognosis of Stargardt’s disease.
Methods. Ninety-three patients with clinical and genetic diagnosis of Stargardt’s disease, were recruited by the “Referral Center For Hereditary Retinopathies of the Second University of Naples”. A full ophthalmologic evaluation, including central visual acuity measurements with ETDRS charts, biomicroscopy fundus exam and microperimetry was carried out in all patients.
Results. Study of fixation showed unstable fixation in 66.6% (124 eyes) with a mean visual acuity of 0.36; relatively unstable fixation in 16.12% (30 eyes) with mean visual acuity of 0.2 and stable fixation in 17.2% (32 eyes) with a mean visual acuity of 0.125. The analysis of the fixation location showed eccentric fixation in 81.18% (151 eyes) associated with a mean visual acuity of 0.44; relatively central fixation in 8.06 % (15 eyes) associated with mean visual acuity of 0.304 and central fixation in 10.75% (20 eyes) associated with mean visual acuity of 0.13. In 52.15% the preferred retinal locus was located of patients in the upper part of the retina, in 5.91% in the lower part, in 3.22% temporally and in 9.67% nasally. Finally, 29.03% of patients retained preferred retinal locus in a central or paracentral region.
Conclusion. This study represents one of the few studies present in literature on the use of microperimetry MP-1 in Stargardt disease, on such a large number of patients. Our study shows that central visual acuity is related to the localization and stability of fixation. Our results, also, demonstrate that in most Stargardt patients the preferred retinal locus is localized in the upper sector. In conclusion, we believe that the information provided by microperimetry MP-1 (location and stability of fixation) allows a better morphological and functional definition of patients with Stargardt’s disease.