The functional impact of subfoveal SD-OCT characteristic on reading acuity in neovascular age related macular degeneration

Abstract

Purpose: To correlate reading acuity in patients with neovascular age-related macular degeneration (nAMD) to specific SD-OCT characteristics of the subfoveal area.

Methods: Fourty four eyes showing untreated nAMD were examined with the Heidelberg Spectralis-OCT. Pateints’ reading acuity (logRAD) was assessed using a German language reading test (Radner Lesetest), visual acuity (logMAR) was assessed using EDTRS charts. Reading- and visual performance was evaluated with respect to the following OCT-findings in the subfoveal area 500x500µm: neovascular complex (NVC), fibrovascular pigment epithelium detachment (fPED), serous pigment epithelium detachment (sPED), subretinal fluid (SRF), intraretinal fluid (IRF) and intraretinal cysts (IRC).

Results: Of 44 eyes with nAMD mean reading acuity in logRAD was 0.72 ± 0.3 and mean visual acuity in logMAR was 0.59 ± 0.28 showing a strong correlation of r=0.821 spearmen (P=0,000). In general, in subfoveal NVC, the mean logRAD score was 0.84 ± 0.24, whereas in NVC with additional cysts the mean logRAD score was 1.0 ± 0.18. With SRF, the mean logRAD was 0.58 ± 0.32, whereas with IRF the mean logRAD was measured at 0.70 ± 0.35. A SPED was associated with a mean logRAD score of 0.37 ± 0.10, a FPED was associated with 0.83 ± 0.26 and FPED with additional cyst revealed a mean logRAD score of 0.92 ± 0.28.

Conclusions: In nAMD, a severe deficiency in reading acuity was observed especially with subfoveal NVC associated with additional cysts and fibrovascular PED overlying cysts. Morphologic changes of the central retina have a direct impact on reading ability.

Keywords: 412 age-related macular degeneration • 672 reading • 453 choroid: neovascularization