June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Individualized mesopic and dark-adapted fundus-controlled perimetry: Longitudinal changes in retinal sensitivity at the border of geographic atrophy.
Author Affiliations & Notes
  • Monika Fleckenstein
    Department of Ophthalmology, University of Utah Health, Salt Lake City, Utah, United States
  • Leon Alexander von der Emde
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Frank G Holz
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Steffen Schmitz-Valckenberg
    Department of Ophthalmology, University of Utah Health, Salt Lake City, Utah, United States
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Maximilian Pfau
    Department of Ophthalmology, University of Bonn, Bonn, Germany
    National Eye Institute, Bethesda, Maryland, United States
  • Footnotes
    Commercial Relationships   Monika Fleckenstein Spouse: AlphaRET, Apellis, Bioeq, Katairo, Kubota Vision, Novartis, Oxurion, Pixium, Roche, SparingVision, Code C (Consultant/Contractor), Spouse: Bayer, Carl Zeiss MediTec, Heidelberg Engineering, Novartis, Roche, Code F (Financial Support), Spouse: STZ GRADE Reading Center, Code O (Owner), Spouse: Apellis, Heidelberg Engineering, Code R (Recipient); Leon von der Emde None; Frank Holz Acucela, Apellis, Bayer, Boehringer-Ingelheim, Bioeq/Formycon, Roche/Genentech, Geuder, Graybug, Gyroscope, Heidelberg Engineering, IvericBio, Kanghong, LinBioscience, Novartis, Oxurion, Pixium Vision, Stealth BioTherapeutics, Zeiss, Code C (Consultant/Contractor), Acucela, Allergan, Apellis, Bayer, Bioeq/Formycon, CenterVue, Ellex, Roche/Genentech, Geuder, Heidelberg Engineering, IvericBio, Kanghong, Novartis, NightStarX, Optos, Pixium Vision, Zeiss, Code F (Financial Support), STZ GRADE Reading Center, Code O (Owner); Steffen Schmitz-Valckenberg AlphaRET, Apellis, Bioeq, Katairo, Kubota Vision, Novartis, Oxurion, Pixium, Roche, SparingVision, Code C (Consultant/Contractor), Bayer, Carl Zeiss MediTec, Heidelberg Engineering, Novartis, Roche, Code F (Financial Support), STZ GRADE Reading Center, Code O (Owner), Apellis, Heidelberg Engineering, Code R (Recipient); Maximilian Pfau Apellis Pharmaceuticals , Code C (Consultant/Contractor)
  • Footnotes
    Support  German Research Foundation (DFG) grants PF 950/1-1 (to M.P.), 658/4-1 and 658/4-2 (to M.F.); BONFOR GEROK Program of the Faculty of Medicine, University of Bonn grants O-137.0022 and O-137.0025 (to M.P.); this work was in part supported by National Institutes of Health Core Grant (EY014800) and an Unrestricted Grant from Research to Prevent Blindness, New York, NY, to the Department of Ophthalmology & Visual Sciences, University of Utah; CenterVue SpA, Padova, Italy, provided research material (Scotopic Macular Integrity Assessment, CenterVue, Padua, Italy) for the conduct of this study.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 875. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Monika Fleckenstein, Leon Alexander von der Emde, Frank G Holz, Steffen Schmitz-Valckenberg, Maximilian Pfau; Individualized mesopic and dark-adapted fundus-controlled perimetry: Longitudinal changes in retinal sensitivity at the border of geographic atrophy.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):875.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To analyze mesopic and dark-adapted (DA) retinal sensitivity changes based on fundus-controlled perimetry (FCP) test patterns designed to the shape of geographic atrophy (GA).

Methods : A total of 40 patients (75.8 ± 8.5 years old; 21 females) were prospectively examined by mesopic, DA cyan, and DA red FCP with the S-MAIA device (CenterVue, Padua, Italy). Test points were placed along iso-hulls (i.e., contour lines) at even distances surrounding the GA boundary at −0.645°, 0.43°, 0.86°, 1.29°, 2.15°, and 3.01° with customized software. Retinal sensitivity was assessed in 40 eyes, with longitudinal data for 29 eyes with a median [IQR] of one follow-up visit [0;2] spanning 2.1 [1.9;2.3] years. Linear mixed model analysis was applied to estimate the change in sensitivity over time with “test point nested in eye” as a random effects term.

Results : At baseline, mesopic, DA cyan, and red testing showed a curvilinear relationship between sensitivity and distance to GA with more severely reduced light sensitivity in the proximity to GA (Figure 1). In the longitudinal analysis (Table 1), for mesopic testing, the estimated marginal mean [95% CI] for sensitivity change was -2.29 [-3.27;-1.31] dB/y at 0.43° and gradually less for more distant test points. For DA cyan testing, the most severe decline in sensitivity was observed for more peripheral loci at 2.15° with -1.38 [-2.09;-0.67] and at 3.01° with -1.38 [-2.09;-0.68] dB/y, due to a floor effect for DA cyan testing at 0.43°. The pattern of decline in DA red sensitivity paralleled the changes in mesopic sensitivity.

Conclusions : Individualized, lesion-tailored mesopic and DA cyan and red FCP testing in eyes with dry AMD detect advancing functional loss prior to GA development. Differential patterns of decline in sensitivity over time - depending on the distance from the GA border and on the mode of FCP testing - reveal a dynamic functional “fingerprint”: Early, pronounced rod-related sensitivity loss in a certain distance to the actual atrophic lesion along with late, pronounced mesopic sensitivity decline colocalizing with the atrophic lesion border. This data demonstrates in vivo the dynamic functional consequences of localized pathobiological processes in advancing GA progression.

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

 

Baseline sensitivity as a function of distance to GA.

Baseline sensitivity as a function of distance to GA.

 

Estimated marginal means for the change in sensitivity over time.

Estimated marginal means for the change in sensitivity over time.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×