Abstract
Purpose::
to investigate the presence of structural and functional retinal impairment in patients with early age related macular degeneration (EARMD)
Methods::
twenty five eyes of fifteen patients (M:F 5:10, age 67±6.5) with EARMD and 14 age matched control eyes (M:F 4:3, age 68.86±9.31) have been included in this cross-sectional observational clinical study. Inclusion criteria: no atrophic region > 200 µm, no exudative lesions and visual acuity ≥ 20/40. Exclusion criteria were: refractive error greater than ±6 diopters, other active or past ocular pathology or surgery. Patients performed a complete ophthalmological examination, fluorescein retinal angiography and 30° color fundus photo. Functional tests included: Humphrey 10-2 SITA-Standard visual field (HFA), Humphrey-Matrix 10-2, and MP-1 microperimetry (macula 12°, 20 dB). Structural tests included: OCT3-Stratus (Fast Macular Thickness Map). Mann-Whitney and Pearson correlation tests were used to analyse data.
Results::
13 eyes with soft and 12 with hard drusen were identified among the EARMD group. All eyes presented lens opacities not worse than NO-2, C-1 and P-1 (LOCS III). OCT fast macular thickness map parameters (Total Macular Volume, Inferior outer, Inferior inner, Temporal outer, Temporal inner thickness with p< 0.05) were found significantly reduced in EARMD compared to control eyes. MP1 microperimetry retinal sensitivity in all investigated regions was found to be significantly worse in EARMD eyes compared to control eyes. Matrix and HFA mean deviation and pattern standard deviation were similar among groups. Foveal thickness was found greater in soft drusen eyes while Inferior outer and Temporal outer thickness have been found to be significantly reduced in soft drusen compared to hard drusen eyes. All functional tests were similar among soft and hard drusen groups.
Conclusions::
EARMD patients show a reduction in macular retinal thickness and a corresponding reduction of retinal sensitivity when tested with MP1 microperimetry compared to normal eyes. Humphrey-Matrix parameters are not influenced by EARMD. Soft drusen eyes show a perifoveal reduction of retinal thickness compared to hard drusen eyes.
Keywords: drusen • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age-related macular degeneration