Abstract
Purpose :
To analyze the subjective and objective metrics in patients with inherited retinal disease (IRD) using microperimeter (MP-3, Nidek Co, Japan), autofluorescence, and spectral-domain optical coherence tomography (SD-OCT) for macular structure-function correlation.
Methods :
This was a retrospective study conducted over 64 eyes of 32 IRD patients. All underwent a complete ophthalmic examination, including SD-OCT, fundus autofluorescence (FAF) and MP-3. The main outcome measures were visual acuity (VA), fixation behavior (by means of mean retinal sensitivity, stability, eccentric distance of fixation, and the number of deep scotoma points in the fovea), macular hypo- or hyperfluorescence, choroidal thickness, and ellipsoid zone (EZ) integrity.
Results :
Mean patient age was 48.69±16.54 years, mean logMAR VA of all eyes was 0.92±1.24, and mean retinal sensitivity was 12.76±9.18dB. Eyes were categorized by VA into good (less than logMAR 1.0) and poor VA (logMAR 1.0 or more). Poor VA was significantly correlated with worse fixation stability at circular regions within 2° and 4° diameters (0.43±0.31 vs. 0.8±0.25, 0.71±0.28 vs. 0.92±0.14, respectively), decreased mean retinal sensitivity (8.37±9.40dB vs. 15.22±8.17dB), more eccentric preferred retinal locations (PRLs), macular hypofluorescence, thinner choroidal thickness, and loss of EZ integrity. With logistic regression analysis, fixation stability at circular regions within 2° diameters of PRLs was independently associated with EZ integrity. In eyes with loss of EZ integrity, those with poor VA were significantly associated with more eccentric PRLs and increasing number of deep scotoma points in the fovea. Furthermore, logMAR VA in eyes with loss of EZ integrity was significantly correlated with fixation stability at circular regions within 2° diameters, mean retinal sensitivity, and eccentric PRLs.
Conclusions :
Identifying fixation location and stability for IRD patients is crucial in analyzing individual macular structure and function. In advanced IRD cases with EZ disruption, MP-3 could be a useful tool in evaluating visual function. Our data suggests that multimodal imaging provides a more comprehensive assessment which may be fundamental in future clinical practices.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.