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Author Spotlight: Understanding Age-Related Macular Degeneration Pathophysiology with QAF Workflow
Published on: May 26, 2023
Longitudinal changes in microperimetry and low luminance visual acuity in age-related macular degeneration
Zhichao Wu1, Lauren N Ayton1, Chi D Luu1
1Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia.
Importance:
There is a need for more sensitive measures of disease in intermediate age-related macular degeneration (AMD) to evaluate novel interventions more effectively and expediently.
Objective:
To determine if microperimetry and low luminance visual acuity can detect functional changes over a short duration of follow-up.
Design, Setting, And Participants:
Prospective longitudinal examination of 49 participants with consecutive AMD and 10 healthy participants in a research clinic from May 1, 2012, to December 31, 2013. Forty-one participants had intermediate AMD, 8 had nonfoveal geographic atrophy due to AMD. Participants underwent microperimetry examinations in 1 eye during a 12-month period at 6-month intervals for participants with AMD and at baseline and 12 months for control participants; low luminance visual acuity was performed at baseline and at 12 months for all participants. Changes in pathological features of intermediate AMD eyes were determined using side-by-side comparisons of color fundus photographs from the initial and final visit as remaining stable, progressed, or improved.
Main Outcomes And Measures:
Microperimetric sensitivity and low luminance visual acuity.
Results:
A reduction in mean (SE) microperimetric pointwise sensitivity was identified at 12 months compared with the baseline for intermediate AMD eyes graded as stable (-0.31 dB [0.10 dB]; P = .003) or worsened (-0.42 dB [0.12 dB]; P < .001) and an improvement in mean (SE) pointwise sensitivity was identified in eyes graded as improved (1.13 dB [0.23 dB]; P < .001). A reduction in mean (SE) pointwise sensitivity was identified in eyes with nonfoveal geographic atrophy at both 6 months (-1.41 dB [0.22 dB]; P < .001) and 12 months compared with the baseline (-2.56 dB [0.22 dB]; P < .001) while a change in mean (SE) pointwise sensitivity was not identified over the 12-month period for control participants (-0.11 dB [0.11 dB]; P = .34). No changes in best-corrected visual acuity or low luminance visual acuity were identified in all groups over the 12-month period (P ≥ .07).
Conclusions And Relevance:
Microperimetry detected subtle changes in visual function over a 12-month period in eyes with intermediate AMD but visual acuity measures did not identify any such changes. These findings suggest that microperimetry is worth exploring as a method for assessing the efficacy of novel interventions for intermediate AMD potentially requiring a shorter duration of follow-up.
Insights
Microperimetry detected subtle visual function changes in intermediate age-related macular degeneration (AMD) over 12 months, while visual acuity did not. This suggests microperimetry may help assess new AMD treatments faster.
Area of Science:
- Ophthalmology
- Vision Science
Background:
- Intermediate age-related macular degeneration (AMD) requires sensitive measures for evaluating new treatments.
- Current methods may not adequately detect early functional changes in intermediate AMD.
Purpose of the Study:
- To assess if microperimetry and low luminance visual acuity can detect functional changes in intermediate AMD over a short follow-up period.
Main Methods:
- A prospective longitudinal study followed 49 participants with intermediate AMD and 10 controls over 12 months.
- Microperimetry and low luminance visual acuity were measured at baseline and 12 months.
- Color fundus photographs assessed pathological changes.
Main Results:
- Microperimetry showed reduced sensitivity in stable or worsened intermediate AMD eyes and improved sensitivity in others.
- Eyes with geographic atrophy showed significant sensitivity reduction over 6 and 12 months.
- No significant changes were observed in best-corrected or low luminance visual acuity for any group.
Conclusions:
- Microperimetry detected subtle visual function changes in intermediate AMD over 12 months, unlike visual acuity measures.
- Microperimetry shows promise for assessing novel intermediate AMD interventions with potentially shorter follow-up durations.
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