Background/Aims To assess the role of microperimetric retinal sensitivity (MPRS) and inner choroid flow deficits (IC FD) in predicting the development of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) in intermediate AMD (i-AMD).
Methods Thirty eyes with i-AMD evaluated at the Doheny-UCLA Eye Centres were enrolled in this prospective IRB-approved study. Subjects underwent several diagnostic tests: (a) 6×6 mm swept-source optical coherence tomography angiography (SS-OCTA) with the IC slab used to quantify the FDs, (b) 20°×20° spectral-domain optical coherence tomography (SD-OCT) to monitor progression to iRORA and (c) scotopic MPRS within an area of 18° centred on the fovea. All subjects were followed-up for 24 months. The baseline IC FD and MPRS were correlated with the development of iRORA. At 24-month follow-up, the stage of AMD was re-assessed and the eyes were divided into two sub-groups based on the development of iRORA.
Results Twenty-eight eyes completed the 2-year follow-up. At baseline, the mean MPRS was 13.40±4.66 dB and the mean IC FD was 27.55±8.67%. The morpho-functional regression showed a significant correlation between baseline MPRS and IC FD and the development of iRORA within 24 months (R2=0.744, p<0.05). A Kaplan–Meier survival curve was fit to determine the cumulative incidence of iRORA over the 24 months.
Conclusions A lower MPRS and greater IC FD at baseline were predictors of progression to iRORA in eyes with i-AMD. These parameters may be useful biomarkers for risk stratification and prognostication.
- Diagnostic tests/Investigation
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Contributors GC and LT contributed equally to this work. GC, LT, FC and SS contributed to the study concept and design, acquisition, analysis or interpretation of data, drafting and critical revision of the manuscript. ARA, MN, Muneeswar Gupta Nittala and FC contributed to the study acquisition and analysis of the data.
Funding GC, LT, ARA, MN, MNG, FC have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. SS: Amgen (C), Allergan (C), Genentech-Roche (C), Oxurion (C), Novartis (C), Regeneron (C), Bayer (C), 4DMT (C), Centervue (C, S), Heidelberg (C, F, S), Optos (C, F, S), Carl Zeiss Meditec (F, S), Nidek (S), Topcon (S). C, consultant; F, financial support; S, non remunerative.
Competing interests None declared.
Ethics approval The study has been approved by the IRB ‘Ocular Imaging Study’— UCL (IRB # 15-000083).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information.
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