September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Six-month-change in microperimetric mean sensitivity, fixation location and fixation stability in Stargardt disease: The prospective ProgStar study
Author Affiliations & Notes
  • Shazia Khan
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Xiangrong Kong
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Rupert Wolfgang Strauss
    Experimental Ophthalmology, Moorfields Eye Hosp & Inst of Ophthal UCL, London, United Kingdom
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Mohamed A Ibrahim
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Etienne M. Schonbach
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Saddek Mohand-Said
    Ophthalmology, CHNO des Quinze-Vingts / Inserm CIC 1423, Paris, France
  • Michel Michaelides
    Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom
  • David G Birch
    Ophthalmology, Retina Foundation of the Southwest, Dallas, Texas, United States
  • Janet S Sunness
    Ophthalmology, Greater Baltimore Medical Center, Baltimore, Maryland, United States
  • Srinivas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, United States
  • Hendrik P Scholl
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Shazia Khan, None; Xiangrong Kong, None; Rupert Strauss, None; Mohamed Ibrahim, None; Etienne Schonbach, None; Saddek Mohand-Said, None; Michel Michaelides, None; David Birch, None; Janet Sunness, None; Srinivas Sadda, Allergan (F), Allergan (C), Avalanche (C), Bayer (C), Carl Zeiss Meditec (F), Genentech (F), Genentech (C), Iconic (C), Novartis (C), Optos (F), Optos (C), Regeneron (C), Stem Cells Inc (C), Thrombogenics (C); Hendrik Scholl, None
  • Footnotes
    Support  Supported by the Foundation Fighting Blindness Clinical Research Institute (FFB CRI) and a grant to FFB CRI by the U.S. Department of Defense USAMRMC TATRC, Fort Meade, Maryland (grant numbers W81-XWH-07-1-0720 and W81XWH-09-2-0189).
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Shazia Khan, Xiangrong Kong, Rupert Wolfgang Strauss, Mohamed A Ibrahim, Etienne M. Schonbach, Saddek Mohand-Said, Michel Michaelides, David G Birch, Janet S Sunness, Srinivas R Sadda, Hendrik P Scholl; Six-month-change in microperimetric mean sensitivity, fixation location and fixation stability in Stargardt disease: The prospective ProgStar study. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Better retinal sensitivity as well as central and stable fixation have been associated with better visual function in Stargardt disease (STGD1), but there is a paucity of data regarding the longitudinal changes of these findings. Here, we report 6-month data from a prospective, multicenter, longitudinal, observational study to describe the changes in microperimetric mean sensitivity (MS), fixation location and fixation stability in a large cohort of STGD1 patients.

Methods : Patients with ABCA4-related STGD1 underwent testing with the MP-1 Microperimeter (Nidek Technologies) which measured the MS of the central 10° of the macula, fixation stability through the 95.4 %-Bivariate Contour Ellipse Area (BCEA), and fixation location as the distance of the preferred retinal locus (PRL) from the anatomical fovea. Microperimetric testing was performed and images were graded at baseline and at month 6. Linear models with generalized estimating equations were used to analyze the change in MP-1 measures while accounting for between-eye correlations.

Results : A total of 238 patients (105 males, 44 %) and 403 eyes were enrolled. At baseline, median age was 32 years (mean, 33.8 years; range, 7- 69 years), median MS was 12.1 dB (mean, 10.8 dB; range, 0 dB-19.9 dB), median PRL eccentricity was 6° (mean, 6.2°; range, 0°- 25°) and the median BCEA was 21.4 deg2 (mean, 31.1 deg2; range, 0.370 deg2- 267 deg2). At month 6, the mean loss of MS was 0.48 dB (95% CI -0.75 dB, -0.23 dB; p= 0.0003). The mean change of eccentricity of fixation location from the anatomical fovea was 0.066° (95% CI -0.27°, 0.40°; p=0.698) and the mean change of the BCEA was -0.47 deg2 (95% CI -3.6 deg2, 2.7 deg2; p=0.771); thus, both improvements and worsening of fixation location and stability were observed. Each degree of increased PRL eccentricity after 6 months was associated with an increase in BCEA of 2.97 deg2 (95% CI 1.95 deg2, 4.00 deg2; p<0.0001).

Conclusions : After a 6-month follow up, there was a statistically but not clinically significant loss in mean sensitivity (MS) of 0.48 dB. This was not associated with significant changes in fixation location and stability after 6 months.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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