April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Relationship between 2-Color Microperimetry (2-MP) and the Inner Segment Ellipsoid (IS/E) Integrity in Subjects with Dry Age-Related Macular Degeneration (AMD)
Author Affiliations & Notes
  • Karl G Csaky
    Ophthalmology, Retina Foundation of the Southwest, Dallas, TX
  • Markie Dowing
    Ophthalmology, Retina Foundation of the Southwest, Dallas, TX
  • Joost Felius
    Ophthalmology, Retina Foundation of the Southwest, Dallas, TX
  • Tim Holmes
    Lickenbrock Technologies, St Louis, MO
  • Footnotes
    Commercial Relationships Karl Csaky, Acucela (C), Allergan (C), Allergan (F), Bausch and Lomb (C), Genentech (C), Genentech (F), GSK (C), Heidelberg Engineering (C), Merck (C), Notal Vision (C), Novartis (R), Ophthotech (C), Ophthotech (I), Santen (C), Santen (F); Markie Dowing, None; Joost Felius, None; Tim Holmes, Lickenbrock Technologies (E)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5214. doi:https://doi.org/
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    • Get Citation

      Karl G Csaky, Markie Dowing, Joost Felius, Tim Holmes; The Relationship between 2-Color Microperimetry (2-MP) and the Inner Segment Ellipsoid (IS/E) Integrity in Subjects with Dry Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2014;55(13):5214. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Scotopic and photopic sensitivities are decreased in AMD but the relationship to anatomic changes within the retina remains unclear. Specifically the IS/E integrity may be an anatomic indicator of photoreceptor function, but the assessment of this layer has been hampered by challenges to segmentation and en-face integrity quantitation. The goals of the present study were 1) to develop and test novel image analysis software capable of isolating and quantifying IS/E integrity and 2) to understand the relationship between the calculated IS/E integrity and altered photoreceptor function as determined by changes in in 2-MP.

 
Methods
 

One eye from patients with early AMD (n=3), intermediate AMD (n=4) or central geographic atrophy (GA) (n=3) was examined. Following dark adaptation, rod-mediated sensitivities or following light exposure cone-mediated sensitivities were measured at 9-22 locations per eye within the retinal arcades using a modified fundus microperimeter (MP-1S, Nidek Technologies). Test locations were set up on a grid pattern and avoided areas of GA. IS/E integrity was determined using novel software that isolated the IS/E from 46 sequential scans centered on the fovea and spaced 15 μm apart of a spectral domain optical coherence tomography unit (Heidelberg Engineering) utilizing eigenvector calculations to calculate flow vectors that allowed for IS/E anomalies. Integrity values were divided into 5 distinct categories based on numeric scores of IS/E pixel intensities.

 
Results
 

There was a statistical decrease in rod sensitivities in the geographic atrophy (GA) group compared with other AMD stages (P=0.025); early AMD (21.4 ± 4.7 dB), intermediate AMD (20.0 ± 5.2 DB) and GA (16.4 ± 8.0) - (mean ± SD). IS/E integrity values were assessed within subjects and demonstrated that both rod- and cone-mediated sensitivity were significantly associated with IS/E integrity category (linear mixed effects model, P=0.0002 and P=0.0037, respectively).

 
Conclusions
 

In this preliminary study, changes in both rod and cone sensitivities were statistically associated with IS/E integrity as determined by a novel software algorithm. Thus direct assessment of IS/E integrity may be a useful approach to understanding photoreceptor function in dry AMD.

 
Keywords: 412 age-related macular degeneration • 550 imaging/image analysis: clinical • 754 visual acuity  
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