Microperimetry in age-related macular degeneration: association with macular morphology assessed by optical coherence tomography

Br J Ophthalmol. 2019 Dec;103(12):1769-1776. doi: 10.1136/bjophthalmol-2018-313316. Epub 2019 Feb 1.

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.

Keywords: degeneration; diagnostic tests/Investigation; imaging; macula; neovascularisation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Fluorescein Angiography
  • Geographic Atrophy / diagnosis
  • Geographic Atrophy / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Retina / physiopathology*
  • Tomography, Optical Coherence
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology
  • Visual Field Tests*
  • Visual Fields / physiology*
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / physiopathology*