Abstract
Purpose:
To evaluate the impact of drusenoid pigment epithelium detachment (dPED) due to age-related macular degeneration (AMD) on retinal function beyond best corrected visual acuity (BCVA).
Methods:
Thirteen eyes of 11 patients with dPED due to AMD were included (age 74 ± 3.2 years). All underwent volume SD-OCT, enhanced-depth-imaging (EDI) SD-OCT, fluorescence angiography and confocal scanning laser ophthalmoscopy (cSLO) infrared (IR) imaging as well as multifocal electroretinography (mfERG) and microperimetry (MP). A new dPED morphology score was introduced containing lesion height, lesion diameter, migration of hyperreflective foci (HRF), presence of vitelliform-like material in the subretinal space or presence of subretinal fluid and localization of the fovea in relation to dPED lesion. Subsequently, the score was correlated to fixation stability, measurements from mfERG and MP. Data were compared to age-matched healthy controls.
Results:
Mean BCVA was 0.5 (+0.18). Mean height and mean diameter of dPED were 308 + 122 μm and 2331 + 967 μm. Three dPED showed no HRF in cSLO IR images, three displayed mild stage of HRF and seven had severe HRF. Three patients showed subretinal fluid and seven patients showed subfoveal localization of dPED lesion. MP showed a dislocated fixation towards the edge of dPED in four patients. Mean retinal sensitivity in MP and mean amplitudes in mfERG measured in dPED-affected areas differed significantly compared to healthy controls. While no correlation was found between dPED morphology score and BCVA, particularly eyes with a high dPED morphology score revealed distinctly decreased values in functional measurements.
Conclusions:
In contrast to BCVA, determination of dPED morphology score offers a quick impression of true functional impairment caused by dPED.
Keywords: 412 age-related macular degeneration •
504 drusen •
509 electroretinography: clinical