June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Evidence for association between impaired visual function and structurally defined sub-phenotypes in intermediate AMD – A MACUSTAR study report
Charlotte Behning; Hannah M P Dunbar; Marlene Sassmannshausen; sarah thiele; Alison Binns; Bethany Elora Higgins; Jan H. Terheyden; Adnan Tufail; Sergio Leal; Nadia Zakaria; Frank G Holz; Matthias Schmid; Robert P Finger; David Crabb; Steffen Schmitz-Valckenberg; Ulrich F O Luhmann
Author Affiliations & Notes
  • Charlotte Behning
    Institute of Medical Biometry, Informatics and Epidemiology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Hannah M P Dunbar
    UCL Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Marlene Sassmannshausen
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • sarah thiele
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Alison Binns
    City University of London, London, London, United Kingdom
  • Bethany Elora Higgins
    City University of London, London, London, United Kingdom
    UCL Institute of Ophthalmology, University College London, London, London, United Kingdom
  • Jan H. Terheyden
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Adnan Tufail
    UCL Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Sergio Leal
    Bayer Consumer Care AG, Basel, Basel-Stadt, Switzerland
  • Nadia Zakaria
    Novartis Institutes for BioMedical Research Inc, Cambridge, Massachusetts, United States
  • Frank G Holz
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Matthias Schmid
    Institute of Medical Biometry, Informatics and Epidemiology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Robert P Finger
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • David Crabb
    City University of London, London, London, United Kingdom
  • Steffen Schmitz-Valckenberg
    Department of Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
    University of Utah Health John A Moran Eye Center, Salt Lake City, Utah, United States
  • Ulrich F O Luhmann
    Roche Pharmaceutical Research and Early Development, Translational Medicine Ophthalmology, F Hoffmann-La Roche AG Research and Development Division, Basel, Basel-Stadt, Switzerland
  • Footnotes
    Commercial Relationships   Charlotte Behning None; Hannah Dunbar Boeringer Ingelheim, Code C (Consultant/Contractor); Marlene Sassmannshausen Heidelberg Engineering, CenterVue, Carl Zeiss MedicTec, Code F (Financial Support); sarah thiele Carl Zeiss MedicTec AG, CenterVue, Heidelberg Engineering, Optos, Novartis, Code F (Financial Support), Allergan, Bayer, Heidelberg Engineering, Novartis, Code R (Recipient); Alison Binns Apparatus and method for retinal measurement: Patent number: 9492081; 2016, Code P (Patent); Bethany Higgins None; Jan Terheyden Carl Zeiss MedicTec, CenterVue, Heidelberg Engeneering, Optos, Code F (Financial Support), Novartis, Okko, Code R (Recipient); Adnan Tufail Allergan, Allegro, Adverum, Annexon, Apellis, Bayer, Genetech, Heidelberg Engineering, Iveric Bio, Kanghong Pharmaceutical, Kodiak Sciences, Novartis, Oxurion, Roche, Code C (Consultant/Contractor), Bayer, Novartis, Code F (Financial Support); Sergio Leal Bayer Consumer Care AG, Code E (Employment); Nadia Zakaria Employee of Novartis, Code E (Employment); Frank Holz Acucela, Alexion, Alzheon, Apellis, Astellas, Bayer, Boehringer-Ingelheim, Bioeq/Formycon, CenterVue, Roche/Genentech, Geuder, Graybug, Gyroscope, Heidelberg Engineering, IvericBio, Janssen, Kanghong, LinBioscience, Novartis, Oxurion, Pixium Vision, Oxurion, Stealth BioTherapeutics, Zeiss, Code C (Consultant/Contractor), Acucela, Allergan, Apellis, Bayer, Bioeq/Formycon, CenterVue, Roche/Genentech, Geuder, Heidelberg Engineering, IvericBio, Kanghong, NightStarX, Novartis, Optos, Pixium Vision, Zeiss, Code F (Financial Support), GRADE Reading Center , Code O (Owner); Matthias Schmid None; Robert Finger :Alimera, Apellis, Bayer, Böhringer-Ingelheim, Novartis, ODOS, Oxford Innovation, ProGenerika, Roche/Genentech, Code C (Consultant/Contractor), Biogen, CentreVue (now Icare), Heidelberg Engineering, Zeiss Meditec, Code F (Financial Support); David Crabb :AbbVie/Allergan, Apellis, Janssen, Code C (Consultant/Contractor), AbbVie/Allergan, Apellis, Santen, Code F (Financial Support), bbVie/Allergan, Santen, Thea, Glaukos, Code R (Recipient); Steffen Schmitz-Valckenberg AlphaRET, Apellis, Bioeq, Katairo, Kubota Vision, Novartis, 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); Ulrich Luhmann F. Hoffmann-La Roche Ltd, Code E (Employment)
  • Footnotes
    Support  This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 116076. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA and Carl Zeiss Meditec AG.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2761. doi:
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      Charlotte Behning, Hannah M P Dunbar, Marlene Sassmannshausen, sarah thiele, Alison Binns, Bethany Elora Higgins, Jan H. Terheyden, Adnan Tufail, Sergio Leal, Nadia Zakaria, Frank G Holz, Matthias Schmid, Robert P Finger, David Crabb, Steffen Schmitz-Valckenberg, Ulrich F O Luhmann; Evidence for association between impaired visual function and structurally defined sub-phenotypes in intermediate AMD – A MACUSTAR study report. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2761.

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Abstract

Purpose : To investigate whether associations between imaging biomarkers and visual function (VF) measures in patients with intermediate age-related macular degeneration (iAMD) found in the cross-sectional MACUSTAR cohort can be replicated in the larger baseline longitudinal dataset.

Methods : All iAMD patients in the MACUSTAR study underwent the following VF assessments: Best Corrected Visual Acuity (BCVA), Low Luminance Visual Acuity (LLVA), Moorfields Acuity Test (MAT), Pelli Robson Contrast Sensitivity (CS), International Reading Speed Test (IReST), Mesopic (MesAT) and Scotopic (ScoAT) average thresholds (S-MAIA microperimetry) and AdaptDx Rod Intercept Time (RIT), followed by multimodal imaging (colour fundus and confocal infrared photography, fundus autofluorescence and spectral domain optical coherence tomography). The following imaging-based biomarkers were determined by a central reading centre: pigmentary abnormalities (PA), reticular pseudodrusen (RPD), incomplete and complete retinal pigment epithelium and outer retinal atrophy (iRORA and cRORA). VF performance was compared between iAMD patients with each feature absent(-) and present(+) using Wilcoxon tests. To account for multiple testing, associations with p<0.001 are reported.

Results : A total of 585 study eyes from 585 iAMD patients were included. Of those, 287 (49.1%) had PA, 159 (27.2%) had RPD, 69 (11.8%) had iRORA and 54 (9.2%) had cRORA. Median performance on BCVA, LLVA, MAT, CS, MesAT, ScoAT and RIT was worse in RPD+ compared to RPD- (p<0.0007). CS and ScoAT were reduced in PA+ compared to PA- (p<0.0001). CS, MesAT and ScoAT were reduced in iRORA+ compared to iRORA- (p<0.0003) and cRORA+ compared to cRORA- (p<0.0005).

Conclusions : Baseline longitudinal MACUSTAR data corroborate findings in the smaller cross-sectional cohort that though being ascribed the same AMD disease stage, eyes with iAMD+RPD and iAMD+cRORA had poorer low luminance and contrast vision than other iAMD eyes. Similar associations were found for presence of iRORA and PA. Whether presence of these structural biomarkers is associated with faster progression to late AMD will be assessed once longitudinal MACUSTAR data are available.

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

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2024 Association for Research in Vision and Ophthalmology.
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