Local OCT Structural Correlates of Deep Visual Sensitivity Defects in Early Atrophic Age-Related Macular Degeneration

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Early atrophic AMD is characterized by retinal pigment epithelium (RPE) and outer retinal degeneration.
• Understanding structural correlates of visual function is crucial for treatment development.

Purpose of the Study:

• To identify specific Optical Coherence Tomography (OCT) structural features associated with deep visual sensitivity defects in early atrophic AMD.
• To correlate localized OCT findings with microperimetry-measured visual sensitivity thresholds.

Main Methods:

• A prospective observational study involving 40 participants with early atrophic AMD.
• High-density microperimetry and swept-source OCT angiography were performed on targeted atrophic lesions.
• Seven OCT-defined atrophy features were manually annotated and analyzed for association with visual sensitivity defects.

Main Results:

• All analyzed OCT features were individually associated with visual sensitivity defects.
• Hypertransmission, complete RPE loss, ELM disruption, and ONL thickness were independently associated with defects in multivariable analysis.
• A prediction model using these four features demonstrated superior predictive performance compared to single features.

Conclusions:

• Hypertransmission, complete RPE loss, ELM disruption, and ONL thickness are key OCT indicators of deep visual sensitivity defects in early atrophic AMD.
• These structural markers are valuable for assessing the efficacy of interventions targeting atrophic AMD.
• Correlating anatomical changes with functional outcomes is essential for evaluating treatment benefits and functional preservation.