Implantation of the First IMT Macular Lens in Age-Related Macular Degeneration (Literature Review)

2019 ◽  
Vol 4 (4) ◽  
pp. 56-60
Author(s):  
M. M. Bikbov ◽  
O. I. Orenburkina ◽  
A. E. Babushkin
Keyword(s):  
Visual Field ◽  
Macular Degeneration ◽  
Peripheral Vision ◽  
Age Related Macular Degeneration ◽  
Central Vision ◽  
Central Visual Field ◽  
Visual Rehabilitation ◽  
Age Related ◽  
Terminal Form ◽  
Special Programs

This review presents the characteristics and results of clinical studies of patients with age-related macular degeneration implanted with the developed for this purpose first macular IOL – intraocular macular telescope (IMT). This lens was designed specifically for patients with the most severe or terminal form of age-related macular degeneration and is designed for monocular implantation to provide central vision while maintaining peripheral vision of the paired eye, which is important for maintaining the balance and orientation of patients. This device allows patients to see both in dynamic and static situations in the near, intermediate and far ranges. The disadvantages of this lens are a decrease in the visual field and depth of focus (which excludes its bilateral implantation), the need for a large (10–12 mm) incision for implantation, which can cause an increase in corneal astigmatism and the risk of complications, in particular, the pupillary block with an increase in intraocular pressure. There are also difficulties in the study of the fundus after its implantation to assess the small changes in the macula or to identify possible postoperative complications after cataract surgery (macular oedema, etc.). Also after the implantation of this lens, there is need for special programs of visual rehabilitation. The patient’s commitment to the rehabilitation measures for the adaptation of the central visual field of the operated eye with the peripheral vision of the second eye is crucial for success of the IMT macular telescope implantation procedure.

scholarly journals Scleral gas permeable contact lenses as a possible way of visual rehabilitation of patients with age-related macular degeneration

The Eye ◽  
2019 ◽  
Vol 125 (2019-1) ◽  
pp. 33-40
Author(s):  
Alexander Myagkov ◽  
Maria Kovalevskaya ◽  
Oksana Pererva
Keyword(s):  
Macular Degeneration ◽  
Contact Lenses ◽  
Gas Permeability ◽  
Age Related Macular Degeneration ◽  
Central Visual Field ◽  
Optimal Method ◽  
Visual Rehabilitation ◽  
Age Related ◽  
Quality Of Vision

Low visual acuity, loss of the central visual field, metamorphopsia, distortion of lines and decreased contrast sensitivity cause reduced quality of vision in patients with age-related macular degeneration (AMD). Currently existing methods of visual rehabilitation for patients with AMD, such as telescopic intraocular and scleral lenses, are functionally and cosmetically unacceptable. The use of intraocular telescopic lenses is limited by the high risk of postoperative complications, low functional parameters, as well as by difficult ophthalmoscopy and lasting adaptation of patients. Telescopic scleral lenses have а low resolution, contain impermeable to oxygen parts and require wearing special switching glasses. However, scleral lenses have potential in developing an optimal method for vision correction in patients with AMD due to the presence of following advantages: wide optical zone, gas permeability, correction of refractive astigmatism in presbyopic patients and alleviation of dry eye symptoms. In conclusion, further clinical researches are required to develop a method for improving the quality of vision in patients with AMD by using scleral lenses with an objective test for evaluating the effectiveness of correction – the 3D computer-automated threshold Amsler grid test (3D-CTAG).

Circular vection in patients with age-related macular degeneration

1999 ◽  
Vol 9 (4) ◽  
pp. 287-291
Author(s):  
Hiroaki Fushiki ◽  
Satoru Takata ◽  
Yasunori Nagaki ◽  
Yukio Watanabe
Keyword(s):  
Visual Field ◽  
Macular Degeneration ◽  
Matched Control ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Central Visual Field ◽  
Matched Control Group ◽  
Circular Vection ◽  
Age Related ◽  
Significant Difference

We have used optokinetic stimulation in patients with unilateral age-related macular degeneration (AMD) and central scotoma to investigate the possible contribution of the central visual field to circular vection (CV). Six patients aged 42–73 years with unilateral AMD and an aged-matched control group of nine elderly adults aged 47–75 years were examined. Monocular visual field defects were verified with the Goldmann perimeter by kinetic perimetry. The device used to induce CV was a random dot pattern projected onto a hemispherical dome with a radius of 75 cm. The pattern was rotated horizontally at a constant acceleration of 1 deg/s 2 . Monocular stimuli were randomly repeated two to three times in both temporal-nasal (T-N) and nasal-temporal (N-T) directions. The latency of onset of CV was measured for each stimulus presentation. In the age-matched control group the CV latencies varied from 4.2 to 72.0 s. In each case, however, the CV latencies were stable. No significant differences in CV latencies were found between right and left eyes in both stimulus directions ( p > 0.05). In patients with AMD, no statistically significant difference in CV latency was found between the affected and unaffected eyes ( p > 0.05). Marked central visual field loss in AMD does not significantly impair peripherally induced CV. Our results are compatible with the hypothesis that the peripheral retina dominates CV.

scholarly journals LMI-SI and Scharioth Additional Intraocular Lenses for Age-Related Macular Degeneration. Review

2019 ◽  
Vol 16 (1S) ◽  
pp. 7-11
Author(s):  
M. M. Bikbov ◽  
O. I. Orenburkina
Keyword(s):  
Macular Degeneration ◽  
Peripheral Vision ◽  
Extraction Procedure ◽  
Cataract Extraction ◽  
Intraocular Lenses ◽  
Age Related Macular Degeneration ◽  
Posterior Chamber ◽  
Macular Dystrophy ◽  
Visual Rehabilitation ◽  
Age Related

Currently, the treatment of neovascular age-related macular degeneration (AMD) includes: intravitreal injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, etc.), photodynamic therapy, surgical treatment (subretinal surgery, recombinant tissue plasminogen activator + gas, macula translocation) and etc. Rehabilitation of these patients is carried out using special optical tools (glasses, magnifying lenses, loupes, electronic devices). Classic external devices for the correction of very poor eyesight are not convenient to use: they are often lost or forgotten at home, not adapted for constant wear, people are embarrassed to use them in public places. This review presents the characteristics and clinical results of the implantation of two intraocular lenses, the Lipschitz Macular Implant (LMI-SI) and the Scharioth Macula lenses, in patients with age-related macular degeneration (AMD). These IOL can be implanted during standard phacoemulsification with the implantation of usual posterior chamber IOL or years after the cataract extraction, which makes them unique among other lenses that are implanted only during the cataract extraction procedure. The Lipschitz Macular Implant (Israel, 2013) is a rigid IOL made of polymethyl methacrylate (PMMA), implanted in a capsular bag, it requires an incision up to 6 mm. A positive feature of the Scharioth Macula lens (1stQ GmbH, Germany, 2017) is the smallest incision needed for implantation — no more than 3 mm. This lens consists of a biocompatible hydrophilic acryl with a UV filter, the peripheral zone of the lens is optically neutral, the square design excludes its free rotation. Also, this lens can be used as therapy for progressive macular dystrophy of various etiologies. The additional macular IOLs do not affect peripheral vision, reduce binocularity when reading, and require complex visual rehabilitation.

Visual field deficits in early age-related macular degeneration

1994 ◽  
Vol 34 (3) ◽  
pp. 409-413 ◽  
Author(s):  
Michael J. Tolentino ◽  
Sumiko Miller ◽  
Alexander R. Gaudio ◽  
Michael A. Sandberg
Keyword(s):  
Visual Field ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Early Age ◽  
Age Related ◽  
Visual Field Deficits

scholarly journals Causes of low vision and use of optical aids in the elderly

2004 ◽  
Vol 59 (4) ◽  
pp. 157-160 ◽  
Author(s):  
Keila Monteiro de Carvalho ◽  
Gelse Beatriz Martins Monteiro ◽  
Cassiano Rodrigues Isaac ◽  
Lineu Oto Shiroma ◽  
Marcela Scabello Amaral
Keyword(s):  
Macular Degeneration ◽  
Elderly Population ◽  
Low Vision ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Rehabilitation Service ◽  
Visual Rehabilitation ◽  
Cross Sectional ◽  
Age Related

PURPOSE: To determine the causes of low vision in an elderly population attended by a university visual rehabilitation service and to check for the use of prescribed optical aids. METHOD: A cross-sectional study was carried out on patients aged 60 years or over attending for the first time a university low vision service in 2001. Ophthalmic reevaluation and interview were performed by means of a structured questionnaire in 2002. RESULTS: The sample comprised 50 subjects aged between 60 and 90 years. Severe low vision (<FONT FACE=Symbol><</FONT>20/200) was present in 68.0% of patients. The main cause of low vision was age-related macular degeneration (44.0%). Regarding literacy, 16.0% were illiterate and 72.0% had completed fundamental schooling. Thirty-one patients (62.0%) had been prescribed optical aids; 54.8% of these patients stated that they use them. A majority (70.6%) held a favorable opinion of these aids. CONCLUSIONS: The main cause of low vision was age-related macular degeneration. Approximately half of those receiving prescriptions reported actually using the aids in their daily activities. Making best use of residual vision in the elderly population with visual impairment is a priority, given the social context, if the independence necessary for enhanced quality of life is to be achieved.

scholarly journals Photovoltaic Restoration of Central Vision in Atrophic Age-Related Macular Degeneration

Ophthalmology ◽  
2020 ◽  
Vol 127 (8) ◽  
pp. 1097-1104 ◽  
Author(s):  
Daniel Palanker ◽  
Yannick Le Mer ◽  
Saddek Mohand-Said ◽  
Mahiul Muqit ◽  
Jose A. Sahel
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Central Vision ◽  
Age Related

Telescope Implant—Changing Visual Expectations and Evolving the Standard of Care for End-stage Age-related Macular Degeneration Patients

2015 ◽  
Vol 08 (02) ◽  
pp. 116
Author(s):  
Charles C Wykoff ◽  
Keyword(s):  
Macular Degeneration ◽  
Daily Living ◽  
Standard Of Care ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Visual Rehabilitation ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Age Related ◽  
End Stage

End-stage age-related macular degeneration (AMD) affects approximately 1.8 million Americans and limits older adults’ ability to perform activities of daily living. No current pharmaceutical options exist for visual improvement in these patients. The telescope implant is the only Food and Drug Administration approved intraocular device for visual rehabilitation in end-stage AMD patients, with either bilateral geographic atrophy or disciform scarring, who are phakic (in at least one eye) with best spectacle-corrected visual acuity of 20/160–20/800 or worse in both eyes.

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