Computer-Based Visual Evaluation as a Screening Tool after Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitors

Purpose: To evaluate the visual acuity (VA) of patients following intravitreal (IVT) injections. Methods: 15 patients received 3 anti-vascular-endothelial-growth-factor (VEGF) injections on a monthly basis. Prior to each injection as well as 2 months after, the patients received a standardized examination including Snellen VA and optical coherence tomography (OCT). During this time the patients were trained to evaluate their central VA by 3 computer-based tests: (a) VA was examined by the patient on a computer-based vision chart and (b) subjectively categorized as 'same', 'worse' or 'better'; (c) the edge of metamorphopsia was outlined on a digital Amsler grid. Results: VA improved during the 3 injections by >= 2 lines (13/15). The assessment demonstrated subjective improvement (13/15), i.e. a gain of 2 or more lines or decreased central metamorphopsia (12/15). Reevaluation 2 months later demonstrated a decline of >= 1 Snellen line or increased retinal thickness on OCT (8/15), and a decline of >= 1 line or an enlarged metamorphopsia in the computer-based tests (6/15). Conclusion: Our pilot study demonstrated a good correlation between the professional examination and the computer-based assessment. Selected patients can define their visual impairment. A web-based VA evaluation may help to screen patients after IVT injections on a regular basis at home. Copyright (C) 2008 S. Karger AG, Basel