Macular Functional and Morphological Changes in Intermediate Age-Related Maculopathy

Abstract

Purpose The purpose of this study was to evaluate macular preganglionic function and to verify its relationship with retinal and choroidal morphology in patients with intermediate age-related macular degeneration (iAMD) patients. Methods All included patients performed multifocal electroretinogram (mfERG) for investigating on macular function from the central 15° of foveal eccentricity, spectral domain optical coherence tomography (SD-OCT) for studying retinal structure, enhanced depth imaging OCT (EDI-OCT) for the measure of choroidal vascularity index (CVI), and OCT-angiography (OCTA) for the evaluation of vessel density (VD) in the superficial and deep capillary plexus, and choriocapillaris (CC) layer. Results Twenty-seven patients with iAMD and 20 age-matched control eyes were analyzed. Significantly ( P < 0.01) delayed and reduced mfERG responses in the central 0 to 2.5°, paracentral 2.5 to 5°, and overall 0 to 5° areas, as well as increased CVI values in both foveal (1 mm centered to the fovea) and fovea + parafovea areas (3 mm centered to the fovea), increased foveal and parafoveal (annular area of 1–3 mm centered to the fovea) retinal pigment epithelium thickness, and volume and parafoveal outer retinal volume were found in iAMD eyes as compared to controls. Moreover, iAMD eyes showed significantly ( P < 0.01) reduced foveal and parafoveal OCTA-VD values in the CC layer when compared to controls. In the iAMD group, not significant ( P > 0.01) correlations were found between morphological and functional parameters. Conclusions Our findings support a dysfunction of photoreceptors and bipolar cells in both foveal and parafoveal areas in the presence of outer retina, CC, and choroidal structural changes, however, not significantly correlated. The observed enlargement of luminal choroidal area (measured by CVI) is possibly compensatory to CC vascular insufficiency.

Radial Peripapillary Capillary Plexus Sparing and Underlying Retinal Vascular Impairment in Intermediate Age-Related Macular Degeneration

“… 12 – 17 , 19 , 24 Some studies, however, suggest no significant changes in either vascular complex in the early stages of AMD. 18 , 20 – 23 The disparity in results may be due, in part, to confounders, whereby only some studies controlled for the potential confounding effect of systemic vascular disease 13 , 14 , 16 , 18 , 20 , 22 or SSI, 13 , 19 , 23 which has significant correlation to OCTA outcomes. 25 , 26 , 26 , 27 Additionally, some studies used unvalidated postimage processing or maintained unprocessed manufacturer software imaging, 18 , 22 which could affect outcomes because postimage processing has been demonstrated to be a vital step in mitigating noise and improving diagnostic sensitivity and specificity of OCTA imaging.…”

Electroretinographic Assessment in Joubert Syndrome: A Suggested Objective Method to Evaluate the Effectiveness of Future Targeted Treatment

“…This can because the data we obtained by performing different types of ERG recordings reflect the bioelectrical activity of different retinal elements of the whole retina with a negligible contribution of the macular region, which is strictly implicated in the visual acuity assessment. For this requirement, it would be useful to perform multifocal ERG recordings that, by applying the “ring analysis” [ 28 – 33 ], allow a functional evaluation of cones and bipolar cells located in the macular area [ 34 ]. Nevertheless, the multifocal ERG recordings require a particular ability to maintain a stable fixation for the entire duration of the examination and we believe that cannot be correctly performed in children with a low visual acuity such as our patients with JS-RD.…”

Outer retina dysfunction and choriocapillaris impairment in type 1 diabetes

“…In NoDR and NPDR eyes, mfERG was recorded according to the ISCEV standards 29 and to our previously published method by the VERIS Clinic 4.9 (Electro-Diagnostic Imaging, San Mateo, CA, USA) system 9 , 30 – 32 .…”