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Julia Steinberg, Marlene Saßmannshausen, Monika Fleckenstein, Frank G Holz, Steffen Schmitz-Valckenberg; Longitudinal analysis of structural and functional changes in patients with reticular drusen and age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2017;58(8):16. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Previously, we have reported in a cross-sectional analysis about the spatial correlation of reduction of partial outer retinal thickness with scotopic retinal sensitivity in areas with reticular drusen (RDR) of patients with age-related macular degeneration (AMD). Here, we report about the longitudinal analysis of structural and functional changes over two years.
Eleven eyes of 9 patients (mean age 75.7 years, range 66-86) with longitudinal data (mean 24.1 months, range 22-25) were included. Retinal areas with RDR (category 1) and no visible pathological alterations (category 2) were identified by combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging (Spectralis, Heidelberg Engineering, Heidelberg, Germany). Scotopic fundus-controlled perimetry (MP1S, Nidek Technologies, Padova, Italy) was performed and the thickness of the partial outer retina (outer border of the outer plexiform layer to the inner border of the ellipsoid zone) was determinated in each eye at baseline and follow-up.
In 4 eyes, a change of the neutral density (ND) filter was noticed (2 eyes switched to a stronger filter; 2 eyes switched to a weaker filter). Three eyes remained with the ND 1.0 filter while 4 eyes showed the ND 2.0 filter at both examination times. In the latter 7 eyes, the number of stimulus points within category 1 increased over time (mean 5.1 ± 6.7 (range -4-15). For filter 2, there was a trend for a larger decrease in sensitivity for category 1 (mean -5.4 dB ± 2.2 (range -8- to -3)) than category 2 (mean -2.2 dB ± 1.3 (range -4 to 0), p=0.109). For filter 1, these changes were less pronounced (category 1 mean -1.2 dB ± 1.6 (range -5- to -1)), category 2 (mean 0.5 dB ± 1.4 (range -1 to 2), p=0.273). The analysis of the partial outer retinal thickness for all 7 eyes revealed a mean difference between the two examinations of 0.1 µm ± 1.4 (range -3 to 3) for category 1 and -5.5 µm ± 5.1 (range -16- to -1) for category 2, p=0.028.
The results confirm the topographic association of reduced outer retinal thickness with reduced scotopic sensitivity in RDR areas and thus underscore the relevance of RDR on rod photoreceptor structure and function in AMD eyes. Over two years, overall only minor progression of structural and functional changes was detected in this limited number of eyes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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