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Clinical science
Microperimetry in age-related macular degeneration: association with macular morphology assessed by optical coherence tomography
  1. Miin Roh1,2,
  2. Inês Laíns1,3,4,5,
  3. Hyun Joon Shin6,
  4. Dong Ho Park1,7,
  5. Steven Mach1,
  6. Demetrios G Vavvas1,
  7. Ivana K Kim1,
  8. Joan W Miller1,
  9. Deeba Husain1,
  10. John B Miller1
  1. 1 Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Department of Ophthalmology, Beetham Eye Institute, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Department of Ophthalmology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  4. 4 Association for Innovation and Biomedical Research on Light (AIBILI), Coimbra, Portugal
  5. 5 Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  6. 6 Division of Global Health Equity, Division of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Department of Ophthalmology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
  1. Correspondence to Dr Deeba Husain, Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA; deeba_husain{at}meei.harvard.edu

Abstract

Background/aims Microperimetry is a technique that is increasingly used to assess visual function in age-related macular degeneration (AMD). In this study, we aimed to evaluate the relationship between retinal sensitivity measured with macular integrity assessment (MAIA) microperimetry and optical coherence tomography (OCT)-based macular morphology in AMD.

Methods Prospective, cross-sectional study. All participants were imaged with colour fundus photographs used for AMD staging (Age-Related Eye Disease Study scale), spectral-domain OCT (Spectralis, Heidelberg, Germany) and swept-source OCT (Topcon, Japan). Threshold retinal sensitivity of the central 10° diameter circle was assessed with the full-threshold, 37-point protocol of the MAIA microperimetry device (Centervue, Italy). Univariable and multivariable multilevel mixed-effect linear regression models were used for analysis.

Results We included 102 eyes with AMD and 46 control eyes. Multivariable analysis revealed that older age (p<0.0001), advanced AMD stage (p<0.0001) and reduced retinal thickness (p<0.0001) were associated with decreased mean retinal sensitivity. No associations were found between choroidal thickness and retinal sensitivity within the macula. Within the 10° diameter circle of the macula, the presence of ellipsoid disruption, subretinal fluid, atrophy and fibrosis, and outer retinal tubulation on OCT images was also associated with decreased retinal sensitivity (all p<0.05).

Conclusions There is an association between TRS as determined by MAIA microperimetry and several OCT structural parameters across various stages of AMD. This study highlights the relevance of microperimetry as a functional outcome measure for AMD.

  • degeneration
  • diagnostic tests/Investigation
  • imaging
  • macula
  • neovascularisation

https://doi.org/10.1136/bjophthalmol-2018-313316

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    Footnotes

    • DH and JBM are joint senior authors.

    • MR and IL are joint first authors.

    • Presented at This work is accepted for oral presentation at the Second International Swept Source Optical Coherence Tomography and Angiography conference 2018.

    • Contributors MR, IL and DH conceived and planned the project. DGV, IKK, JWM, JBM,DH, MR, IL, HJS, DHP and SM carried out the project starting from obtaining consent from the patients, clinical examination of participants including obtaining images. MR, IL, DHP, SM, HJS processed and analysed the data and image. MR and HJS performed statistical analysis of this project. MR, IL and HJS interpreted the results and wrote the manuscript with input from DHP, DGV, IKK, JWM, JBM and DH. All authors discussed the results and commented on the manuscript.

    • Funding This study was financially supported by the Miller Retina Research Fund (Mass. Eye and Ear), the Champalimaud Vision Award (JWM), the unrestricted departmental grant from Research to Prevent Blindness, New York, and the Portuguese Foundation for Science and Technology/Harvard Medical School Portugal Program (HMSP-ICJ/006/2013). None of the aforementioned funding organisations had any role in the design or conduct of this research. DHP is financially supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2017R1D1A1B03027966) and the Korea Health Technology R&D Project of the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI16C1501).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Institutional Review Boards of MEE.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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