July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Light sensitivity within areas of geographic atrophy secondary to age-related macular degeneration
Author Affiliations & Notes
  • Steffen Schmitz-Valckenberg
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Monika Fleckenstein
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Leon Alexander von der Emde
    Ophthalmology, University of Bonn, Bonn, Germany
  • Chantal Dysli
    Ophthalmology, University of Bonn, Bonn, Germany
    Department of Ophthalmology and Department of Clinical Research, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
  • Sarah Thiele
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Philipp T. Möller
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Moritz Lindner
    Nuffield Department of Clinical Neurosciences, The Nuffield Laboratory of Ophthalmology, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, United Kingdom
    Ophthalmology, University of Bonn, Bonn, Germany
  • Jennifer Nadal
    Institute for Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, Bonn, Germany
  • Matthias Schmid
    Institute for Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, Bonn, Germany
  • Frank G Holz
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Maximilian Pfau
    Ophthalmology, University of Bonn, Bonn, Germany
    GRADE Reading Center, Bonn, Germany
  • Footnotes
    Commercial Relationships   Steffen Schmitz-Valckenberg, Acucela (F), Alcon/Novartis (C), Alcon/Novartis (F), Alcon/Novartis (R), Allergan (C), Allergan (F), Allergan (R), Bayer (F), Bayer (R), Bioeq/Formycon (C), Bioeq/Formycon (F), Centervue (F), Galimedix (C), Genentech/Roche (F), Genentech/Roche (R), Heidelberg Engineering (F), Katairo (F), Optos (F); Monika Fleckenstein, Alcon/Novartis (F), Alcon/Novartis (R), Bayer (F), Bayer (R), Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Heidelberg Engineering (R), Roche (C), US20140303013 A1 (P); Leon von der Emde, Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Optos (F); Chantal Dysli, Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Optos (F); Sarah Thiele, Bayer (R), Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Heidelberg Engineering (R), Novartis (F), Optos (F); Philipp Möller, Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Optos (F); Moritz Lindner, Allergan (F), Carl Zeiss MediTec (F), Centervue (F), Genentech (F), Heidelberg Engineering (F), Optos (F); Jennifer Nadal, Genentech (F); Matthias Schmid, Bayer (C), Galimedix (C); Frank Holz, Acucela (C), Acucela (R), Acucela (F), Allergan (F), Allergan (R), Appelis (C), Appelis (R), Bayer (C), Bayer (F), Bayer (R), Bioeq/Formycon (C), Bioeq/Formycon (F), Boehringer-Ingelheim (C), Centervue (F), Ellex (R), Galimedix (C), Geuder (C), Grayburg Vision (C), Grayburg Vision (R), Heidelberg Engineering (F), Heidelberg Engineering (C), Heidelberg Engineering (R), Roche/Genentech (F), Roche/Genentech (C), Roche/Genentech (R); Maximilian Pfau, Carl Zeiss MediTec (F), Centervue (F), Heidelberg Engineering (F), Novartis (F), Optos (F)
  • Footnotes
    Support  BONFOR GEROK Program, Faculty of Medicine, University of Bonn, Grant No O-137.0022 and O-137.0025 to MP DFG Grant FL 658/4-1 and FL 658/4-2 DFG Grant Ho1926/3-1
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1167. doi:https://doi.org/
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      Steffen Schmitz-Valckenberg, Monika Fleckenstein, Leon Alexander von der Emde, Chantal Dysli, Sarah Thiele, Philipp T. Möller, Moritz Lindner, Jennifer Nadal, Matthias Schmid, Frank G Holz, Maximilian Pfau; Light sensitivity within areas of geographic atrophy secondary to age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1167. doi: https://doi.org/.

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

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Abstract

Purpose : To investigate residual sensitivity within areas of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

Methods : Mesopic (achromatic stimuli, Goldmann III) and dark-adapted (DA) cyan and red light sensitivity were investigated using fundus-controlled perimetry (S-MAIA, CenterVue, Italy). Customized software was used to create patient-tailored perimetry grids based on fundus autofluorescence (FAF) imaging. Test-points were placed within GA along an "iso-hull" with a distance of -0.645° to the atrophy boundary. The false-positive response rate was determined with suprathreshold stimuli to the optic disc (Heijl-Krakau method), and used to compute the expected sensitivities for the assumption of absolute scotomata with consideration of the staircase strategy. The outermost visible retinal layer on spectral-domain optical coherence tomography (SD-OCT) at the location of each test-point was determined.

Results : Thirty eyes of 30 patients (76.4 ± 7.1 years; 17 female) with GA from the prospective natural progression study DSGA (Directional Spread in Geographic Atrophy; NCT02051998) were analyzed. A total of 1128 threshold determinations were performed within areas of GA. The measured sensitivities were significantly (p<0.01) higher than the expected values for absolute scotomata (mean difference ± standard error [i.e. measurement – model-based expectation] of +7.29 ± 0.95 dB for mesopic, +2.76 ± 0.63 dB for DA cyan, and +4.88 ± 0.81 dB for DA red testing). For mesopic testing and DA red testing, the presence of the residual outer nuclear layer had a significant effect on this discrepancy (p<0.001). There was no effect of fixation stability or any other reliability index on this discrepancy

Conclusions : Measured sensitivities within the inner junctional zone of GA may not be purely explained by patient-specific false-positive response rates or other reliability indices. The marked influence of the outer retinal configuration on measured sensitivity may be indicative of residual cone function within GA at the inner junctional zone.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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