Correlation between components of newly diagnosed exudative age‐related macular degeneration lesion and focal retinal sensitivity

Abstract

ABSTRACT.Purpose: To analyse lesion components determining retinal sensitivity in microperimetry in eyes with newly diagnosed exudative age-related macular degeneration (AMD).Methods: Visual acuity, contrast sensitivity, microperimetry, optical coherence tomography (OCT), and fluorescein (FA) and indocyanine green (ICGA) angiographies of 23 eyes of 23 patients were analysed. Central microperimetry grids with 28 test stimulus sites were automatically aligned with three-dimensional OCTs and manually aligned with angiographies. Thicknesses of the neuroretina, neuroepithelial detachment (NED), retinal pigment epithelial (RPE) elevation and subretinal tissue were measured under the 644 microperimetry stimulus sites. Areas of classic and occult choroidal neovascularizations (CNVs), subretinal and intraretinal haemorrhage, and late hyperfluorescence in ICGA were identified. The impact of the lesion components on retinal sensitivity was evaluated with correlation analysis and multivariate modelling.Results: Decreased retinal sensitivity correlated significantly with the presence of CNV, haemorrhage, subretinal tissue and RPE elevation. Out of the OCT parameters, the most important determinant of sensitivity was the thickness of RPE elevation (Spearman's rho, r = )0.202, p < 0.0001). The thicknesses of subretinal tissue (r = )0.168, p < 0.0001) and NED had weaker effects (r = )0.147, p < 0.0001), and the neuroretinal thickness remained nonsignificant. In multivariate modelling, RPE elevation and subretinal tissue in OCT, CNV membranes in angiographies and haemorrhage had the strongest impacts on retinal sensitivity. Conclusion:The most important lesion components affecting retinal function were RPE elevation and subretinal tissue in OCT as well as neovascular membranes and haemorrhage in angiographies. NED and neuroretinal thickening remained less significant.

A Tablet-Based Retinal Function Test in Neovascular Age-Related Macular Degeneration Eyes and At-Risk Fellow Eye

“…The results of our study suggest that the iPad application is able to detect differences in retinal sensitivity related to the underlying pathologic changes associated with AMD, similar to that reported with formal microperimetry. 29 – 32 When looking at our cohort of treatment eyes with nAMD, we noticed a general lower mean retinal sensitivity of 24.1 dB compared to the at-risk fellow eye (28.8 dB). While sensitivity associated with areas of atrophy, RPE disturbance, and absent EZ had significant reductions in mean retinal sensitivities ( Table 5 ), we were unable to show significant reduced sensitivity in areas with IRF and SRF compared to an averaged nAMD eye.…”

Multimodal evaluation of macular function in age-related macular degeneration

“…With the use of fmERG, Nishihara et al reported that, in eyes with neovascular AMD, the amplitude of each wave was reduced to 29% to 35% of that of the control eyes [26]. With the use of microperimetry, Sulzbacher et al [24] and Hautamäki et al [27] reported more recently that retinal sensitivity was markedly decreased within the area of CNV, macular edema, hemorrhage, subretinal fluid, or PED in eyes with neovascular AMD. In our patients with neovascular AMD, cystoid macular edema was seen in 21%, serous retinal detachment was seen in 74%, and PED was seen in 89% of the patients, and thickness of the fovea in the neurosensory retina was significantly increased.…”

The use of microperimetry in assessing visual function in age-related macular degeneration

“…Microperimetry was undertaken by the Nidek MP1 or MP1-S in 29 of the 52 included articles 3,5,9,12,16,17,23,25,[32][33][34][35]39,41,43,45,48,49,51,52,[55][56][57][59][60][61][62][63]68 by the Nidek MP3 in 1 27 , by the MAIA in 13 4,6,11,65,[69][70][71][72][73][74][75][76][77] , by the Optos Spectral OCT/SLO in 7 13,20,[28][29][30]38,53 and by the Rodenstock SLO microperimeter in two articles 18,…”

“…Fifteen included studies used microperimetry alongside other measures of visual function in individuals with AMD 3,5,11,18,23,30,43,45,48,49,56,69,71,72,77 .In early AMD (International Classification to a lesser extent, with reading speed (r=0.37 all p<0.001) 56 . In those undergoing anti-VEGF treatment, however, no association was present between the MS and either VA or CS 30,43 .…”