Abstract
Purpose:
To evaluate macular function using multimodality in eyes with age-related macular degeneration (AMD) at various stages.
Methods:
Macular function in 20 control eyes (20 subjects), 17 eyes (17 patients) with large drusen, 18 eyes (18 patients) with drusenoid pigment epithelial detachment (PED), and 19 eyes (19 patients) with neovascular AMD were examined by a Landolt chart for visual acuity; retinal sensitivity was measured by microperimetry, and focal macular electroretinography (fmERG) was performed. In all of these eyes, retinal morphology was examined using optical coherence tomography.
Results:
Eyes with neovascular AMD showed morphologic changes in the neurosensory retina as well as marked deterioration of macular function in all parameters measured with the Landolt chart, fmERG, and microperimetry. Eyes with large drusen showed only minimal morphologic changes in the neurosensory retina. In this large drusen group, although retinal sensitivity at the central point was significantly decreased (P = .0063), other parameters in macular function were well preserved. In eyes with drusenoid PED, structure of the neurosensory retina was well preserved while foveal thickness was significantly increased (P = .013). Macular function of these eyes was significantly deteriorated, with VA, amplitude of the a-wave and b-wave, and the retinal sensitivity being markedly decreased. In addition, the area of PED was correlated with amplitude of the photopic negative response, latency of the a- and b-waves, and retinal sensitivity within the central 4° or 8° region.
Conclusions:
Multimodal evaluation demonstrates a significant decrease in macular function in drusenoid PED and in neovascular AMD.