June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
MICROPERIMETRY ASSESSMENT OF SCAR LESIONS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Author Affiliations & Notes
  • Valentina Folegani
    L. Sacco Hospital, MIlan, Milan, Italy
  • Francesco Romano
    L. Sacco Hospital, MIlan, Milan, Italy
  • Carlo Briolini
    L. Sacco Hospital, MIlan, Milan, Italy
  • Mariano Cozzi
    L. Sacco Hospital, MIlan, Milan, Italy
  • Alice Bertoni
    L. Sacco Hospital, MIlan, Milan, Italy
  • Marco Pellegrini
    L. Sacco Hospital, MIlan, Milan, Italy
  • Alessandro Invernizzi
    L. Sacco Hospital, MIlan, Milan, Italy
  • Giovanni Staurenghi
    L. Sacco Hospital, MIlan, Milan, Italy
  • Footnotes
    Commercial Relationships   Valentina Folegani None; Francesco Romano None; Carlo Briolini None; Mariano Cozzi None; Alice Bertoni None; Marco Pellegrini None; Alessandro Invernizzi None; Giovanni Staurenghi None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2200. doi:
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      Valentina Folegani, Francesco Romano, Carlo Briolini, Mariano Cozzi, Alice Bertoni, Marco Pellegrini, Alessandro Invernizzi, Giovanni Staurenghi; MICROPERIMETRY ASSESSMENT OF SCAR LESIONS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2200.

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

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Abstract

Purpose : To analyze retinal sensitivity (RS) over macular areas affected by fibrosis in neovascular age-related macular degeneration (nAMD) using microperimetry

Methods : Observational, cross-sectional study including 40 eyes (40 patients,21 females) affected by inactive scar lesions due to nAMD.
Patients underwent visual acuity(VA), mesopic and dual-color scotopic microperimetry centered on the scar(MAIA-S; CenterVue),color fundus photography(CFP), optical coherence tomography (OCT) and blue autofluorescence (BAF).
To measure RS, Infrared images provided by S-MAIA and CFPs were imported in ImageJ and co-registered: the average of sensitivity values within the involved area was calculated.
Scars were graded as fibrotic or non-fibrotic on CFP as described by CATT study and subdivided based on the OCT classification proposed by Souied: underneath retinal pigment epithelium (type A, sub-RPE), mixed sub-retinal and sub-RPE (type B) and purely subretinal (type C). Outer retinal layers’ (ORL) status, pseudodrusen, central subfield thickness and subfoveal choroidal thickness (SCT) were evaluated on OCT.

Results : Mean age of our cohort was 76.7±8.7 years.
Overall, 14 lesions(35%) were graded as non-fibrotic and 26 as fibrotic(65%).
Eyes with non-fibrotic lesions had better VA (p=0.002) and higher mesopic and red scotopic RS(p<0.001).
Based on OCT, 14 eyes had fibrovascular scars without fibrosis(35%), 8 had type A fibrosis(20%), 6 type B(15%) and 12 type C(30%).
Eyes without fibrosis or with type A fibrosis showed better VA and higher mesopic and red scotopic RS compared with eyes affected by type B-C fibrosis (p<0.001). No significant differences were found for cyan scotopic RS(all p>0.05).
On multivariate analysis, mesopic and red scotopic RS were negatively associated with fibrosis and rarefaction of ORL on OCT (p<0.05), while cyan scotopic RS was meaningfully affected by reduced SCT and ORL rarefaction(p<0.05).

Conclusions : VA has limitations as functional endopoint in AMD: our study is the first to assess macular function with microperimetry over areas affected by scars.
Our results confirm that eyes with sub-RPE fibrosis(type A) maintain better functional outcomes under mesopic conditions compared with subretinal ones(type B-C). The lack of significance under cyan scotopic conditions suggests a preferential rod impairment over neovascular membranes or might be due to a floor effect exerted by the underlying AMD affection.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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