Earliest symptoms caused by neovascular membranes in the macula
A. M. Fine, M. J. Elman, J. E. Ebert, P. A. Prestia, J. S. Starr and S. L. Fine
One hundred three patients with neovascular maculopathy and relatively
recent vision loss were surveyed to determine the most frequent symptoms
and to assess the reliability of the Amsler grid in helping patients to
detect early symptoms. Blurred vision and distortion, most often with near
vision, were the most frequent first symptoms reported by patients. Of 49
patients who said that they were observing the Amsler grid on a regular
basis, only five indicated that the Amsler grid abnormality was the first
visual symptom. However, all but five of 49 patients did notice an Amsler
grid abnormality during the office examination, suggesting noncompliance as
the probable explanation for failure to detect an Amsler grid abnormality
earlier. Patients at risk for neovascular maculopathy should be encouraged
to assess a variety of visual functions--including reading vision, color
saturation, and image clarity--in addition to observing the Amsler grid, in
order to help them detect the earliest symptoms of submacular fluid from a
potentially treatable neovascular membrane.
