Peripheral Manifestations in Age Related Macular Degeneration: A Review of Imaging and Findings

Abstract

Purpose: To review novel findings in research with ultra-widefield imaging for analysis of peripheral manifestations in macular degeneration (AMD). We introduce the evolving widefield imaging modalities while summarizing the analytical techniques used in data collection of peripheral retinal findings thus far. Our review provides a summary of advancements to date and a commentary on future direction for AMD research. Methods: This is a literature review of all significant publications focused on the relationship between AMD and the retinal periphery conducted within the last two decades. Results and Conclusion: Promising research has been undertaken to elucidate peripheral retinal manifestations in macular degeneration using novel methodology. Advancements in ultra-widefield imaging and fundus autofluorescence have allowed us to elucidate peripheral retinal pigmentary changes, drusen deposition, and much more. Novel grid overlay techniques have been introduced to aid in analyzing these changes for pattern recognition and grouping of findings. This review discusses these findings in detail, providing evidence for the pan-retinal manifestations of AMD. Inter-study discordance in analytical approach highlights a need for more systematic future study.

Age-Related Macular Degeneration: Epidemiology, Pathophysiology, Diagnosis, and Treatment

“…Vitamins C and E, carotenoids, lutein, and zeaxanthin all play a role in the retina's healthy defense against oxidative processes. Additionally, the presence of a significant structural lipid at the level of cones called docosahexaenoic acid (DHA) affects membrane permeability and inhibits the growth of new blood vessels [5].…”

“…The two primary kinds of late-stage AMD that might exist are neovascular (also known as wet or exudative) and non-neovascular (also referred to as atrophic, dry, or non-exudative) AMD. The quality of life of those who are affected is substantially damaged by AMD's progression into its late stages, which results in central vision loss, severe and irreversible visual impairment, and legal blindness [5].…”

Visual cortex anodal transcranial direct current stimulation does not alter reading performance for Chinese presented character-by-character to normal peripheral vision in older adults

“…However, reading abilities vary widely in AMD patients depending on their remaining vision and the location of their preferred retinal locus ( Fletcher et al, 1999 ; Altinbay et al, 2016 ; Farzaneh et al, 2021 ). It has also been argued that AMD is accompanied by negative peripheral retinal manifestations because of the increased prevalence of peripheral autofluorescence abnormalities [see Pivovar and Oellers (2021) for a review]. Hence, the remaining peripheral visual function might vary substantially across patients.…”

Visual cortex anodal tDCS does not alter reading performance for Chinese presented character-by-character to normal peripheral vision

“…However, reading abilities vary widely in AMD patients depending on their remaining vision and the location of their preferred retinal locus 19-21 . It has also been argued that AMD is accompanied by negative peripheral retinal manifestations because of the increased prevalence of peripheral autofluorescence abnormalities (see Pivovar & Oellers 22 for a recent review). Hence, the remaining peripheral visual function might vary substantially across patients.…”