Extrafoveal photostress recovery test in glaucoma and idiopathic central serous chorioretinopathy

Abstract

Background/aims-A photostress recovery test was designed to diVerentiate macular diseases from optic nerve disorders, but recently an abnormal recovery time was reported in glaucoma. The purpose of this study was to search for the diVerence in abnormality of the photostress recovery test between glaucoma and idiopathic central serous chorioretinopathy (ICSC). Methods-This study involved 21 normal subjects, 14 patients, with ICSC and 10 patients with primary open angle glaucoma (POAG). A scanning laser ophthalmoscope (SLO) was used with microperimetry for bleaching the test point and measuring the recovery of sensitivity. Photostress recovery time (SLO-PSRT) could be measured at extrafoveal points outside and inside the affected area. The initial sensitivity change and the time constant of recovery after bleaching were calculated by fitting an exponential equation to the data. Results-In normal subjects, neither the initial sensitivity change nor the time constant were correlated with the location of the test point. In 14 patients with ICSC, the initial sensitivity change in the detached area was significantly smaller than that in the unaVected area which was not significantly diVerent from that in the age matched normal subjects. The time constant in the detached area was significantly longer than that in the unaVected area, which was not significantly diVerent from that in the normal subjects. In 10 patients with POAG, the initial sensitivity change inside and outside the scotoma was not significantly diVerent from that of age matched normal subjects. The time constant inside the scotoma was significantly longer than that outside the scotoma, which was not significantly different from that of the age matched normal subjects. Conclusion-Both ICSC and POAG showed a prolonged time constant of recovery, but the initial sensitivity change was reduced only in ICSC. The diVerence in our results between ICSC and POAG may be caused by the diVerence of the retinal pathology. Further, the SLO-PSRT is very useful when the lesion is located outside the fovea.

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“…The earliest studied was central serous retinopathy (CSR). 19 It was initially felt that an increase in recovery time was unique to this condition, as only limited testing on patients with diabetic retinopathy, 23 cystoid macular edema, 45 and AMD 3 had been done. With further investigation, the presence of diabetic macular edema (retinal thickening at or within one disc diameter of center) has been associated with prolonged photostress recovery times.…”

Why HID headlights bother older drivers

“…66 79 Most clinical photostress tests measure how long it takes for visual sensitivity to recover after bright light exposure. Vision is the most common test end point, 39 but pupillary 80 and visually evoked 81 82 recovery times can also be measured. Photostress luminances and exposure durations vary between protocols.…”

Suitability and Repeatability of a Photostress Recovery Test Device, the Macular Degeneration Detector (Mdd-2), for Diabetes and Diabetic Retinopathy Assessment

“…It has previously been shown that PSRT is adversely affected by conditions affecting the macula, including central serous retinopathy, 39 age-related macular degeneration, 25 and diabetic maculopathy. [25][26][27] Disruption of the retinal pigment epithelium-retina relationship, because of serous retinal detachment or macular edema for example, has been shown to be an important factor in the prolongation of PSRT in such macular disease.…”