Abstract
Purpose :
A number of high-risk biomarkers for progression from intermediate age-related macular degeneration (AMD) to late AMD have been defined on optical coherence tomography (OCT). The objective of this study was to define the functional impact of these features using mesopic and scotopic microperimetry (MP).
Methods :
Subjects with early/intermediate AMD enrolled in the Amish Eye Study who had mesopic, and scotopic MP, flash color fundus photography (CFP), and spectral-domain optical coherence tomography (SD-OCT) data were included in this post-hoc analysis. The presence and stage of AMD was assessed on CFPs in accordance with the Beckman scale. Scotopic and mesopic sensitivity were assessed using a Nidek MP-1S (pattern: macular grid, 32 stimuli, threshold strategy 4-2, fixation target 2° circle/cross, white background, stimulus size: Goldmann V). Foveal-centered SD-OCT volume scans [Spectralis OCT (20x20 degrees, 97 B-sans, ART=9) and Cirrus OCT (6x6 mm 512x128)] were reviewed for the presence or absence of previously-described features associated with a higher risk of progression to late AMD. These features include intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), high central drusen volume (CDV) ≥ 0.03mm3, subretinal drusenoid deposits (SDD). A Mann-Whitney U test was used to compare the mean sensitivity (MS), and a p-value ≤ 0.05 was considered statistically significant.
Results :
138 eyes of 69 patients (42 females) were included in this analysis. The mean age of patients was 66.63 ± 9.77 years. The scotopic and mesopic RS’s in eyes with or without the OCT biomarkers are shown in Table 1. Overall, the scotopic MS was lower than mesopic MS in this cohort for all evaluated biomarkers. The mesopic MS was significantly lower in AMD eyes with IHRF or SDD (p < 0.05). The scotopic MS was significantly lower in eyes with IHRF (p<0.05) and was numerically lower in eyes with SDD, though this was not statistically significant. The presence of hCD or high CDV did not seem to be associated with an impact on MS.
Conclusions :
The presence of IHRF is associated with both a lower mesopic and scotopic MS, while the presence of SDD is associated with lower mesopic RS. Larger studies may be required to better define the functional impact of these and other AMD biomarkers.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.