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Role of microperimetry in evaluating disease progression in age-related macular degeneration: a scoping review
Gopinath Madheswaran1, Pinaz Nasim1, Shonraj Ballae Ganeshrao1
1Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Purpose:
Recent research has found variable evidence on the role of mesopic and dark-adapted scotopic microperimetry assessment in age-related macular degeneration. This scoping review summarises how mesopic and scotopic microperimetry can be used to assess disease progression in age-related macular degeneration and identifies gaps in the literature.
Methods:
A population, concept, and context approach was used to develop the search strategy. Ovid MEDLINE, EMBASE, Cochrane Library, PubMed, CINAHL Plus, Web of Science, and SCOPUS databases were used to conduct the literature search. The key search terms used in the databases were age-related macular degeneration and microperimetry.
Results:
Twelve studies were eligible and included in the review. All the studies (n = 12) were conducted in European countries [Germany (9), Italy (2), and the United Kingdom (1)]. The mesopic and scotopic sensitivities were measured using the Nidek scotopic microperimeter (MP1-S) (n = 6), scotopic Macular Integrity Assessment device (S-MAIA) (n = 5), and both MP1-s and S MAIA (n = 1). 83.3% (n = 10) studied (cross-sectional design) on mesopic, scotopic microperimetry and found reduced rod (scotopic) photoreceptors sensitivities compared to cone (mesopic) photoreceptors sensitivities in patients with small and reticular pseudodrusen despite having good visual acuity. Only 16.7% (n = 2) of studies followed participants with reticular drusen/large drusen for three years (longitudinal design) and found reduced scotopic over mesopic sensitivity at baseline and localized mesopic with profound scotopic sensitivity loss during follow-ups.
Conclusion:
Scotopic sensitivity is a better functional indicator than mesopic sensitivity to understand early and intermediate age-related macular degeneration progression. The evidence from longitudinal studies is debatable due to the limited stimuli range of existing microperimeters, smaller sample size, and lost follow-ups.
Insights
Scotopic microperimetry is a better indicator of early age-related macular degeneration (AMD) progression than mesopic assessment. Further research is needed to clarify the role of these tests in AMD management.
Area of Science:
- Ophthalmology
- Vision Science
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- The role of mesopic and scotopic microperimetry in assessing AMD progression remains unclear.
- This review synthesizes current evidence on these microperimetry assessments in AMD.
Purpose of the Study:
- To summarize the application of mesopic and scotopic microperimetry in evaluating AMD progression.
- To identify existing gaps in the literature regarding these functional assessments.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, EMBASE, Cochrane Library, PubMed, CINAHL Plus, Web of Science, SCOPUS).
- Search terms included "age-related macular degeneration" and "microperimetry."
- A population, concept, and context approach guided the search strategy.
Main Results:
- Twelve studies, all from European countries, were included.
- Mesopic and scotopic sensitivities were measured using MP1-S and S-MAIA devices.
- Cross-sectional studies indicated reduced scotopic (rod) photoreceptor sensitivity in early AMD, even with good visual acuity.
- Longitudinal studies showed reduced scotopic over mesopic sensitivity at baseline and localized mesopic with profound scotopic loss during follow-up.
Conclusions:
- Scotopic sensitivity serves as a superior functional indicator for early and intermediate AMD progression compared to mesopic sensitivity.
- Evidence from longitudinal studies is limited and debatable due to factors like small sample sizes and limited microperimeter stimuli range.
