Background/Aims To determine the suitability of functional MRI (fMRI) as an objective measure of macular function following therapeutic intervention; conventional psychophysical measures rely heavily on patient compliance. Methods Twenty patients with neovascular age-related macular degeneration (nAMD) were studied with high-resolution fMRI, visual acuity, reading accuracy and speed, contrast sensitivity (CS) and microperimetry (MP) before and after 3 monthly intravitreal injections of ranibizumab. Population-receptive field retinotopic maps calculated from fMRI data were compared with psychophysical measures and optical coherence tomography. Results Best-corrected visual acuity (BCVA) responders (≥5 letters) showed an increase of 29.5% in activated brain area, while non-responders showed a decrease of 0.8%. Radial histograms over eccentricity allowed quantification of the absolute number of significant voxels and thus differences before and after treatment. Responders showed increases in foveal (α<0.5°) activation, while non-responders did not. Absence of intraretinal fluid and preservation of outer retinal layers was associated with higher numbers of active V1 voxels and better BCVA. Higher voxel numbers were associated with improved reading performance and, less marked, with BCVA, CS and MP. Conclusion The data show that retinotopic mapping using fMRI can successfully be applied objectively to evaluate the therapeutic response in nAMD patients treated with anti-vascular endothelial growth factor therapy. This demonstrates the ability of retinotopic mapping to provide an objective assessment of functional recovery at a cortical level; the technique can therefore be applied, in other degenerative macular diseases, to the assessment of potential therapeutic interventions such as gene therapy or cell replacement therapy. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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黄斑治疗客观功能监测中的视网膜皮质标测


背景/目的 确定功能性 MRI （fMRI） 作为治疗干预后黄斑功能的客观测量的适用性;传统的心理物理学措施在很大程度上依赖于患者的依从性。方法 对 20 例新生血管性年龄相关性黄斑变性 （nAMD） 患者在雷珠单抗玻璃体内注射 3 个月前后进行高分辨率 fMRI 、视力、阅读准确性和速度、对比敏感度 （CS） 和显微视野计 （MP） 的研究。将从 fMRI 数据计算的人群感受野视网膜图与心理物理学测量和光学相干断层扫描进行比较。结果 最佳矫正视力 （BCVA） 反应者 （≥5 个字母） 显示激活的脑区域增加了 29.5%，而无反应者则减少了 0.8%。偏心率上的径向直方图允许量化显着体素的绝对数量，从而量化处理前后的差异。应答者显示中心凹 （α<0.5°） 激活增加，而无应答者则没有。缺乏视网膜内液和保留视网膜外层与活性 V1 体素数量的增加和更好的 BCVA 相关。较高的体素数与改进的读取性能相关，而较少的体素数与 BCVA、CS 和 MP 相关。结论 数据显示，使用 fMRI 的视网膜标测可以成功地客观地应用于评估接受抗血管内皮生长因子治疗的 nAMD 患者的治疗反应。 这证明了视网膜标测能够在皮质水平提供功能恢复的客观评估;因此，该技术可应用于其他退行性黄斑疾病，以评估潜在的治疗干预措施，例如基因疗法或细胞替代疗法。与研究相关的所有数据都包含在文章中或作为补充信息上传。