Association between hyperacuity defects and retinal microstructure in polypoidal choroidal vasculopathy

PURPOSE To improve our understanding of hyperacuity defects measured with preferential hyperacuity perimetry (PHP) by correlating PHP findings with the retinal microstructural changes visible on spectral-domain optical coherence tomography (OCT) in patients with polypoidal choroidal vasculopathy (PCV). MATERIALS AND METHODS Twenty-eight eyes of 28 patients with PCV were retrospectively reviewed. All patients underwent a complete ophthalmologic examination, including best-corrected visual acuity (logMAR) testing, PHP, and OCT. The functional 'PHP test score' and 'total volume of hyperacuity defect zone' were also analyzed. RESULTS Patients were classified based on the hyperacuity defect by PHP, as follows: Hyperacuity defect (n = 17 eyes) group and hyperacuity intact (n = 11 eyes) group. The mean best-corrected visual acuity in the hyperacuity intact group (0.46 ± 0.39) was better than that in the hyperacuity defect group (0.82 ± 0.37) (P = 0.014). The presence of serous retinal detachment and retinal pigment epithelial detachment did not differ significantly between groups (P = 0.120 and P = 0.689, respectively). A disrupted photoreceptor layer was more common in the hyperacuity defect group compared with the hyperacuity intact group (P = 0.0001). Among 17 eyes with a hyperacuity defect, 9 eyes showing intra-retinal pathology (intra-retinal cyst or hard exudates) and had a significantly higher PHP test score and larger total volume of the hyperacuity defect zone than 8 eyes without intra-retinal pathology (P = 0.006 and P = 0.021, respectively). CONCLUSION A hyperacuity defect in PCV was associated with photoreceptor disarrangement. Furthermore, PCV lesions on the inner retina that invaded the photoreceptor layer were associated with a more severe hyperacuity defect.