Abstract
Purpose :
Reduction in macular sensitivity (MS) has been demonstrated in highly myopic (HM) eyes with myopic macular degeneration (MMD) but the correlation with retinal structural changes is still unclear. We aim to evaluate the MS in eyes with various severities of MMD and its association with anatomical parameters of the retina on optical coherence tomography (OCT) and OCT-angiography (OCTA).
Methods :
This is a prospective, observational study that enrolled 138 HM eyes from 82 adult participants from the Singapore National Eye Centre High and Pathologic Myopia clinic. The MS were evaluated using Microperimeter MP-3 comprised of 33 points covering 12° diameter of the macular area. The retinal perfusion density (PD) and retinal thickness (RT) were measured from the 3×3mm2 macular scan obtained by the PLEX Elite 9000 swept source OCTA. Pair-wise differences of MS between varying severities of MMD, and the vasculature-function and structure-function relationship were evaluated by the multivariable linear mixed models, with adjustment of age and axial length (AL).
Results :
Out of 138 eyes, 53 eyes (38.4%) had tessellated fundus, 26 eyes (18.8%) had peripapillary diffuse chorioretinal atrophy (PDCA), 37 eyes (26.8%) had macular diffuse chorioretinal atrophy (MDCA), and 22 eyes (15.9%) had patchy or macular atrophy. MS significantly correlated with BCVA (r=0.32, P<0.001). Reduction in MS occurred in MDCA (P<0.001), and declined with increasing severity of MMD (P <0.001), while changes in BCVA were not significant (P>0.04). Older age (β=-0.08, P<0.001), longer AL (β=-0.32, P=0,005), worse MMD (β≤-2.16, P<0.001), presence of staphyloma involving the macula (β≤-2.98, P<0.001) and fuch’s spot (β=-1.58, P<0.04) were independently associated with declined MS. Decreased deep retinal PD in MMD (β=0.14, P=0.004), but not superficial retinal PD (P=0.33) or RT (P=0.51), was significantly associated with reduction in MS.
Conclusions :
We found a vasculature-function relationship between visual function and deep retinal perfusion density as measured by microperimetry and OCTA respectively. These parameters may serve as early indicators of structural and functional abnormalities in highly myopic eyes with MMD.
This is a 2021 ARVO Annual Meeting abstract.