March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Rod-mediated Sensitivity Loss Precedes SD-OCT Thickness Changes in the Outer Retina of Senior Patients with Intermediate Size Drusen
Author Affiliations & Notes
  • Yuquan Wen
    Retina Foundation of the Southwest, Dallas, Texas
  • Gina M. Mitzel
    Retina Foundation of the Southwest, Dallas, Texas
  • Jane Gilmore
    Retina Foundation of the Southwest, Dallas, Texas
  • Karl G. Csaky
    Retina Foundation of the Southwest, Dallas, Texas
    Ophthalmology, UT Southwestern, Dallas, Texas
  • Donald C. Hood
    Psychology and Ophthalmology, Columbia University, New York, New York
  • Yi-Zhong Wang
    Retina Foundation of the Southwest, Dallas, Texas
    Ophthalmology, UT Southwestern, Dallas, Texas
  • David G. Birch
    Retina Foundation of the Southwest, Dallas, Texas
    Ophthalmology, UT Southwestern, Dallas, Texas
  • Footnotes
    Commercial Relationships  Yuquan Wen, None; Gina M. Mitzel, None; Jane Gilmore, None; Karl G. Csaky, None; Donald C. Hood, TOPCON (F, C); Yi-Zhong Wang, None; David G. Birch, None
  • Footnotes
    Support  NEI R01 09076 and the Foundation Fighting Blindness
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2906. doi:https://doi.org/
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      Yuquan Wen, Gina M. Mitzel, Jane Gilmore, Karl G. Csaky, Donald C. Hood, Yi-Zhong Wang, David G. Birch; Rod-mediated Sensitivity Loss Precedes SD-OCT Thickness Changes in the Outer Retina of Senior Patients with Intermediate Size Drusen. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2906. doi: https://doi.org/.

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

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Abstract

Purpose: : Previous studies suggest that the rod photoreceptors are more affected than the cones in age-related maculopathy (ARM).[1-3] However, it is unclear whether rod- or cone-mediated functional change in these patients precedes identifiable changes shown by in vivo imaging techniques, such as SD-OCT. In this study, we explore the relationship between local rod- and cone- mediated perimetric sensitivity and local thickness in the outer retina in senior patients with intermediate size drusen.

Methods: : Rod- and cone-mediated sensitivities were measured from 37 loci in the central 12° using a modified fundus perimeter (MP-1S, Nidek Technologies). The dynamic range of test stimulus intensities was 0-40 dB for rods and 0-30 dB for cones. Test locations were registered with SD-OCT scans by importing infrared images (Spectralis HRA+OCT) into the MP-1S. Averaged thickness of the outer segment plus (OS+) layer (measured from distal border of retinal pigment epithelium/Bruch’s membrane and choroid to the boundary between photoreceptor inner and outer segments) was calculated for corresponding areas of each test spot (0.86° in diameter). A computer program aided manual segmentation and calculated OS+ thickness. Results from 3 senior patients with intermediate size drusen (78 ± 8 years, mean ± SD) were compared to those from 7 individuals with normal vision (64 ± 9 years, mean ± SD). All patients had best-corrected visual acuity of 20/32 or better (0.1 ± 0.1 logMAR, mean ± SD).

Results: : All 3 patients showed greater loss of rod- than cone-mediated sensitivity. For patient A (age 74 yrs), OS+ thickness across 37 loci averaged 3.5% less than mean normal (p less than 0.05). Average cone-mediated fundus perimetric sensitivity was reduced 1.6 dB, and rod-mediated fundus perimetric sensitivity was reduced 4.8 dB. In patient B, (74 yrs) and patient C (87 yrs), average OS+ thickness was comparable to normal (p larger than 0.15). Cone-mediated fundus perimetric sensitivities were reduced 2.9 dB and 6.3 dB, respectively. However, rod-mediated fundus perimetric sensitivities were reduced 10.8 dB and 11.9 dB, respectively.

Conclusions: : Preliminary results in patients with intermediate size drusen suggest that the change in outer segment thickness is less than expected based upon the loss in cone- or rod-mediated perimetric sensitivity. 1. Curcio Eye 2001, 376-383. 2, Curcio et al IOVS, 1236-1249; 3. Owsley et al Ophthal. 2001. 1196-1202.

Keywords: age-related macular degeneration • visual fields • imaging/image analysis: clinical 
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