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Serena Salvatore, Mohamed A. Genead, J. Jason McAnany, Gerald A. Fishman; Rod Sensitivity Loss in Patients with Stargardt Disease and its Correlation with Retinal Structural Changes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4371.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate rod sensitivity loss in patients with Stargardt disease using a modified MP-1 microperimeter and correlate the sensitivity loss with structural changes observed by spectral-domain optical coherence tomography (SD-OCT) and confocal scanning laser ophthalmoscope (cSLO) infrared imaging.
Nine patients with Stargardt disease and 10 normally sighted control subjects were enrolled.Rod mean sensitivity (MS) was obtained after 45 minutes dark-adaptation using a modified Nidek MP-1 microperimeter with a grid of 37 points covering 14° centered on the anatomical fovea, based on SD-OCT scan. A 2 log unit neutral density filter and a short-pass filter (50%cutoff =500 nm "blue", Edmund Optics NT52532) were added to the optical path of the instrument for the scotopic test. The student t-test was used to compare the MS of the controls and patients (p values <0.05 were considered statistically significant). Additionally,a MS percent difference was obtained by converting the MS values (in dB) to threshold increment luminance values in cd/m2.The percent difference was calculated as MS cd/m2 controls-MS cd/m2 patients/(MS cd/m2 controls+MS cd/m2 patients)/2)x100.Rod sensitivity results were superimposed on cSLO infrared images and compared with corresponding SD-OCT scans.
Mean rod sensitivity± SD was 8.34±1.54dB for the normal controls and 4.03±1.51 dB for Stargardt patients(p<0.001).There was a significant reduction in rod sensitivity,on average 22%, in Stargardt patients compared to normal controls(t=4.90, p<0.01).A rod sensitivity reduction was observed in areas that showed loss or thinning of the retinal pigment epithelial reflectance band on SD-OCT and changes on cSLO infrared images as well as disorganizational loss of the inner-outer segment junction of the photoreceptors and external limiting membrane on SD-OCT examination.
With topographical accuracy, rod sensitivity measurements can be made in Stargardt patients and normal subjects with microperimetry. Rod sensitivity loss correlates well with structural changes.This finding can be useful for the determination of optimal areas for potential improvement of retinal function in Stargardt patients as well as in other macular dystrophies and for monitoring the natural history for visual loss in patients with these diseases.
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