Anatomic Correlates of Microperimetric Sensitivity in Early (e-AMD) and Intermediate Age-Related Macular Degeneration (i-AMD): ALSTAR2 Baseline Cohort

Abstract

Purpose : To better define the relationship between scotopic, mesopic, and photopic microperimetric sensitivity and outer retinal, subretinal, and choroidal substructures on optical coherence tomography (OCT) in eyes with e-AMD and i-AMD.

Methods : Subjects (age ≥ 60 years) with normal retinal health (n=259), e-AMD (n=100), or i-AMD (n=63) in at least one eye underwent eye-tracked spectral domain OCT imaging (Spectralis HRA + OCT2). A deep-learning-derived graph-based algorithm was used to segment 6 outer retinal and choroidal layers (photoreceptor (PR) inner segments, PR outer segments, subretinal drusenoid deposit (SDD), retinal pigment epithelium (RPE), drusen, and choroid). Segmentation errors were corrected by masked graders. Mesopic, scotopic, and photopic fundus-controlled perimetry was performed with 17-stimulus points ≤12° eccentricity. Mean thickness values of outer retinal layers were computed for each stimulus point. Correlations between the mean thickness values and mean sensitivities in eyes with AMD were assessed after adjusting for age.

Results : As seen in Table 1, positive correlations were observed for PR inner and outer segments, RPE, and choroid layers. In contrast, negative correlations were observed for SDD and drusen. Multiple linear regression analyses (Table 2) in e-AMD revealed that only increased PR outer segment thickness was an independent predictor of scotopic sensitivity and only increased choroidal thickness was an independent predictor of mesopic sensitivity, whereas PR outer segment, RPE, and choroidal thickness all contributed to photopic sensitivity. In i-AMD, only increased PR inner segment thickness was an independent predictor of scotopic sensitivity, and only increased RPE thickness was an independent predictor of photopic sensitivity.

Conclusions : Several outer retinal and choroidal features appear to correlate with microperimetric sensitivity in e-AMD and i-AMD. Increasing thickness of SDD and drusen, and thinning of the photoreceptors, RPE, and choroid appear to be associated with worse function.

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

 

Table 1. Age-adjusted Pearson’s correlation coefficient values between mean light sensitivity and outer retinal layer mean thickness
*Highlighted cells indicate a significant p-value < 0.05

 

Table 2. Multiple linear regression analysis results