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Split-Spectrum Amplitude-Decorrelation Optoretinography Detects Impaired Photoreceptor Function in Age-Related
Liang Zhou1,2, Elizabeth White1, Alexander Matteson1,3
1Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
Purpose:
To assess photoreceptor functional impairment in eyes with early-to-intermediate age-related macular degeneration (AMD) using OCT-based split-spectrum amplitude-decorrelation optoretinography (SSADOR).
Design:
Prospective observational comparative study.
Participants:
Adults ≥50 years of age with early or intermediate AMD and age-matched control subjects.
Methods:
Split-spectrum amplitude-decorrelation optoretinography measures flash-evoked OCT amplitude fluctuations within the photoreceptor outer segment band to objectively quantify photoreceptor light responses. We compared SSADOR mean decorrelation between AMD and control eyes within the central 3-mm macula and across ETDRS subfields and evaluated associations with best-corrected visual acuity (BCVA) and drusen volume.
Main Outcome Measures:
Split-spectrum amplitude-decorrelation optoretinography mean decorrelation within ETDRS subfields, as a surrogate marker of the light sensing function of photoreceptors.
Results:
Twenty-two eyes with early-to-intermediate AMD and 12 control eyes were enrolled in the study. Split-spectrum amplitude-decorrelation optoretinography decorrelation was significantly reduced in AMD eyes compared with controls across all ETDRS subfields (all P < 0.05), with the greatest reduction in the fovea (P < 0.001). Although visual inspection showed localized reductions over large drusen, regression analysis revealed no meaningful correlation between SSADOR and drusen volume. In AMD eyes, foveal SSADOR decorrelation was moderately associated with BCVA (R2 = 0.349, P = 0.0002). Split-spectrum amplitude-decorrelation optoretinography distinguished AMD eyes from controls with higher accuracy than BCVA (area under the receiver operating characteristic curve 0.989 vs. 0.795; DeLong test P = 0.002).
Conclusions:
Split-spectrum amplitude-decorrelation optoretinography detected impaired photoreceptor light responses in eyes with early-to-intermediate AMD compared with age-matched controls and outperformed BCVA in differentiating AMD from normal eyes. Split-spectrum amplitude-decorrelation optoretinography decorrelation may serve as a sensitive, objective biomarker for detecting and monitoring early or subtle photoreceptor dysfunction in AMD.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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