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Athanasios Panorgias, Ala Moshiri, Lawrence S Morse, Susanna S Park, Robert J Zawadzki, Ravi Sankar Jonnal, Megan Tillman, John S Werner; Multimodal functional and structural assessment of early and intermediate age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2814.
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To correlate retinal function, quantified by photopic and scotopic mfERGs and microperimetry, with retinal morphology revealed by adaptive-optics OCT (AO-OCT) imaging of patients with early- and intermediate-stage age-related macular degeneration
6 AREDS Category II AMD subjects (69±5 years, mean±1SD), 6 Category III AMD subjects (71±9 years) and 6 age-matched normals (70±6 years) were tested with a battery of functional and structural modalities including photopic and scotopic mfERGs, microperimetry, color fundus and fundus autofluorescence photography, and AO-OCT imaging. The subjects were classified according to their color and autofluorescence fundus photographs. AO-OCT images were obtained with a purpose-built in-house system having 3.5μm isotropic volumetric resolution. Photopic and scotopic mfERGs were recorded with a DTL electrode from one eye using a camera for continuous monitoring of the pupil (Veris, EDI). The stimulus consisted of 103 (200cd/m2, photopic) or 61 (-2.5 log cd/m2, scotopic) hexagons covering an area of ~40ox40o. Central 20o visual fields were assessed with a microperimeter combined with a scanning laser ophthalmoscope for high-resolution confocal retinal fundus imaging (MAIA, CENTERVUE, S.p.A.)
The AMD subjects showed a range of retino-anatomical changes; pigmentary changes with drusen, drusenoid deposits, extended drusen and other outer retinal changes. Despite decreased VA which might compromised fixation in more advanced AMD eyes we were able to acquire AO-OCT images of high quality that show, in unprecedented resolution, these anatomical changes (Figure1). Functional tests generally agree with retinal changes. There was, however, one case with extended retinal dysfunction that could not be explained by anatomical changes
AO-OCT offers high-resolution retinal scans showing details of retinal abnormalities not visible with conventional imaging modalities. Correlation with functional tests provides insight into some anatomical retinal abnormalities and consequences for functional losses
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