Investigation of intermediate AMD with MAIA microperimetry metrics by the PINNACLE Consortium

Abstract

Purpose : Microperimetry (MP) is an important technique to evaluate visual performance in patients with age-related macular degeneration (AMD). In this study we examine a large cohort of patients with intermediate AMD (iAMD) with multiple MP retinal sensitivity and fixation stability metrics.

Methods : This is a cross-sectional analysis of baseline data from 247 patient eyes of the longitudinal, prospective, multicenter and non-interventional PINNACLE study. Best Corrected Visual Acuity (BCVA) and Low Luminance Visual Acuity (LLVA) were measured with ETDRS charts. The MAIA (Centervue, Italy) MP metrics of mean sensitivity (MS), Bivariate Contour Ellipse Area (BCEA) fixation indices (63% and 95%) and percentage of fixation points within 1° and 2° of the foveal center (P1 and P2) were recorded. R code by Josan et al., was applied to obtain 3-D hill of vision surface plots and the total volume (V_TOT) beneath the plots in dB-deg². We report non-normally distributed data with Spearman’s R, medians and interquartile ranges (IQRs).

Results : The following baseline medians and IQRs were measured: BVCA LogMAR 0.02 (-0.06-0.1), LLVA LogMAR 0.32 (0.2-0.45), V_TOT 1656 dB-deg² (1541-1761), MS 24.2 dB (22.8-25.7), P1 93% (82-98), P2 99% (94-100), BCEA63 1 deg² (0.4-2.7), BCEA95 2.9 deg² (1.2-8.1). There was a significant positive correlation for V_TOT and MS (r = 0.98; p < 0.0001). V_TOT exhibited a significant correlation to all MAIA metrics of fixation stability (p < 0.05). All metrics of fixation stability were significantly correlated with each other (p < 0.0001). All MAIA metrics were significantly correlated to BCVA and LLVA (p < 0.01). The performances in most sensitivity and fixation metrics were significantly inversely correlated to age (BCVA: r = 0.33, p < 0.0001; LLVA: r = 0.33, p < 0.0001; V_TOT: r = -0.28, p < 0.0001; MS: r = -0.29, p < 0.0001; P1: r = -0.16, p = 0.01; BCEA63: r = 0.19, p = 0.003; BCEA95: r = 0.19, p = 0.03).

Conclusions : We report reference data for multiple retinal sensitivity and fixation stability metrics in a large cohort of patients with iAMD. Our analysis provides a strong positive correlation between MS, an established metric, and V_TOT , a novel volumetric description of retinal sensitivity. The latter might be more precise, since it eliminates the inaccuracy of averaging. Finally, our data provide evidence for the inverse correlation of retinal functional capacities and age in iAMD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

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