Abstract
Purpose: :
To analyze lesion components determining retinal sensitivity in microperimetry in eyes with newly diagnosed exudative age-related macular degeneration (AMD).
Methods: :
Optical coherence tomography (OCT) - aligned microperimetry was analyzed 23 eyes of 23 patients with a recent exudative AMD lesion. Thicknesses of the neuroretina, neuroepithelial detachment (NED), retinal pigment epithelial (RPE) elevation and subretinal tissue were measured under the 644 microperimetry stimulus sites. Areas of classic and occult choroidal neovascularizations (CNVs), subretinal and intraretinal hemorrhage, and late hyperfluorescence in ICGA were identified. The impact of the lesion components on retinal sensitivity was evaluated with correlation analysis and multivariate modeling.
Results: :
Decreased retinal sensitivity correlated significantly with CNV, hemorrhage, subretinal tissue, RPE elevation, and neuroretinal thickness. Out of the OCT parameters the most important determinants of sensitivity were thickness of RPE elevation (Spearman’s rho, r = -0.329, P = 0.001) and thickness of subretinal tissue (r = -0.302, P =0.001). The effect of neuroretinal thickness (r = -0.132, P = 0.001) was weaker and NED remained non-significant. In multivariate modeling RPE elevation and subretinal tissue in OCT, CNV membranes in angiographies, and hemorrhage had the strongest impacts on retinal sensitivity.
Conclusions: :
The most important lesion components affecting retinal function were RPE elevation and subretinal tissue in OCT as well as neovascular membranes and hemorrhage in angiographies. NED and neuroretinal thickness remained less significant.
Keywords: age-related macular degeneration • clinical research methodology • macula/fovea