Associations Between Contrast Sensitivity, Optical Coherence Tomography Features and Progression From Intermediate to Late Age-related Macular Degeneration.

Establishing associations between structure, function, and clinical outcomes in intermediate age-related macular degeneration (iAMD) remains an unmet need. This study aims to (1) cross-sectionally investigate the relationships between optical coherence tomography (OCT) biomarkers and quantitative contrast sensitivity function (qCSF)-measured contrast sensitivity (CS), and (2) longitudinally assess their relationship with progression from iAMD to late stages of the disease. Cross-sectional and cohort study. Our study was conducted at Massachusetts Eye and Ear (Boston, MA, USA) and included eyes with (1) baseline diagnosis of iAMD, (2) same-day OCT and qCSF test, (3) visual acuity ≥20/200 Snellen, and (4) 24+ months of follow-up. qCSF metrics included the area under the logCSF curve, contrast acuity, and CS thresholds at 1- to 18-cycle-per-degree (cpd). Two independent graders reviewed macular OCT scans for various biomarkers, and outer nuclear layer (ONL) thickness and retinal pigment epithelium (RPE) volume were measured. Progression to wet AMD or geographic atrophy (GA) was confirmed using imaging studies. Generalized linear mixed-effects models assessed associations between qCSF and OCT biomarkers, while Cox regression models evaluated their association with progression to late AMD. We included 205 iAMD eyes from 134 patients (age: 73 [69-78] years; 63% female). Higher RPE volume in the central subfield and a greater number of intraretinal hyperreflective foci were associated with reduced area under the logCSF curve, contrast acuity, and CS at 6 to 12 cpd (P < .05). ONL thinning in the inner ring and a greater number of intraretinal hyperreflective foci were associated with reduced CS at 1 and 3 cpd (P < .05). During follow-up, 35 eyes developed wet AMD (17%) and 53 progressed to GA (26%). subretinal drusenoid deposit, ONL thinning in the inner ring, and reduced CS at 1.5 cpd were associated with wet AMD (P < .05). Higher RPE volume in the inner ring, hyporeflective drusen cores, subretinal drusenoid deposit, higher HRF count, and reduced CS at 1 cpd were associated with GA (P < .05). Our study reveals significant structure-function relationships between OCT biomarkers and qCSF-measured CS in iAMD. These findings highlight the impact of AMD alterations on CS function and offer valuable insights for patient stratification and prognostication in research and clinical settings.

Bennett C ，Romano F ，Vingopoulos F ，Garcia M ，Ding X ，Bannerman A ，Ploumi I ，Ntentakis D ，Stettler I ，Overbey K ，Baldwin G ，Bejjani R ，Garg I ，Rodriguez J ，Laìns I ，Kim LA ，Vavvas D ，Husain D ，Miller JW ，Miller JB ... -  《-》

Decreased Macular Choriocapillaris Perfusion Correlates with Contrast Sensitivity Function in Dry Age-Related Macular Degeneration.

To investigate the relationships between contrast sensitivity (CS), choriocapillaris perfusion, and other structural OCT biomarkers in dry age-related macular degeneration (AMD). Cross-sectional, observational study. One hundred AMD eyes (22 early, 52 intermediate, and 26 late) from 74 patients and 45 control eyes from 37 age-similar subjects. All participants had visual acuity (VA) assessment, quantitative CS function (qCSF) testing, macular OCT, and 6 × 6-mm swept-source OCT angiography scans on the same day. OCT volumes were analyzed for subretinal drusenoid deposits and hyporeflective drusen cores, and to measure thickness of the outer nuclear layer. OCT angiography scans were utilized to calculate drusen volume and inner choroid flow deficit percentage (IC-FD%), and to measure the area of choroidal hypertransmission defects (HTDs). Inner choroid flow deficit percentage was measured from a 16-μm thick choriocapillaris slab after compensation and binarization with Phansalkar's method. Generalized linear mixed-effects models were used to evaluate the associations between functional and structural variables. To explore the associations between qCSF-measured CS, IC-FD%, and various AMD imaging biomarkers. Age-related macular degeneration exhibited significantly reduced qCSF metrics eyes across all stages compared with controls. Univariate analysis revealed significant associations between various imaging biomarkers, reduced qCSF metrics, and VA in both groups. Multivariate analysis confirmed that higher IC-FD% in the central 5 mm was significantly associated with decreases in all qCSF metrics in AMD eyes (β = -0.74 to -0.25, all P < 0.05), but not with VA (P > 0.05). Outer nuclear layer thickness in the central 3 mm correlated with both VA (β = 2.85, P < 0.001) and several qCSF metrics (β = 0.01-0.90, all P < 0.05), especially in AMD eyes. Further, larger HTD areas were associated with decreased VA (β = -0.89, P < 0.001) and reduced CS at low-intermediate frequencies across AMD stages (β = -0.30 to -0.29, P < 0.001). The significant association between IC-FD% in the central 5 mm and qCSF-measured CS reinforces the hypothesis that decreased macular choriocapillaris perfusion contributes to visual function changes in AMD, which are more pronounced in CS than in VA. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Romano F ，Vingopoulos F ，Yuan M ，Ding X ，Garcia M ，Ploumi I ，Rodriguez J ，Garg I ，Tracy JH ，Bannerman A ，Choi H ，Stettler I ，Bennett C ，Overbey KM ，Laìns I ，Kim LA ，Vavvas DG ，Husain D ，Miller JW ，Miller JB ... -  《-》

Progressive Choriocapillaris Changes on Optical Coherence Tomography Angiography Correlate With Stage Progression in AMD.

Romano F ，Ding X ，Yuan M ，Vingopoulos F ，Garg I ，Choi H ，Alvarez R ，Tracy JH ，Finn M ，Razavi P ，Stettler IVM ，Laìns I ，Vavvas DG ，Husain D ，Miller JW ，Miller JB ... -  《-》

Microperimetry and Structural Risk Factors on OCT in Intermediate Age-Related Macular Degeneration.

To determine the relationship between structural biomarkers on OCT that increase the risk of disease progression and microperimetric retinal sensitivity in patients with intermediate age-related macular degeneration (iAMD). Prospective cross-sectional, observational study. Forty-five eyes of 23 patients with iAMD. Patients underwent OCT and microperimetry. OCT scans were evaluated for the risk factors intraretinal hyperreflective foci (HRF), hyporeflectivity within drusenoid lesions (HRDL), subretinal drusenoid deposits, double-layer sign (DLS), and drusen volume. Microperimetric retinal sensitivity was analyzed with a 33-point grid covering the macula. With a novel method of determining what part of the retina corresponded to each microperimetry point, a Voronoi diagram was constructed, dividing the macula in cells consisting of the region nearer to each point than any other. The Voronoi diagram was superimposed on the OCT, making it possible to determine the point-to-point location of the OCT risk factors. Univariable and multivariable linear mixed-effect models were used for analysis. Association between microperimetric retinal sensitivity and OCT risk factors at individual measuring points. One thousand four hundred seventy-nine points of retinal sensitivity and corresponding structural area on OCT were included in this study. Retinal sensitivity was significantly decreased with presence of the OCT risk factors HRF, HRDL, DLS, and drusen volume (all P < 0.001) when analyzed with the univariable linear mixed-effect model. The multivariable model showed a significant decrease of retinal sensitivity with presence of HRF (P < 0.001), DLS (P = 0.025), and greater drusen volume (P < 0.001). Presence of HRF, DLS, and greater drusen volume, all of which increase the risk of disease progression, is significantly and independently associated with decreased microperimetric retinal sensitivity in patients with iAMD. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Thomsen AK ，Gøttsche LF ，Hinnerskov JMV ，Falk MK ，Sørensen TL ... -  《-》

Acquired Vitelliform Lesions in Intermediate Age-Related Macular Degeneration: A Cross Sectional Study.

Lindenberg S ，Mahmoudi A ，Oncel D ，Corradetti G ，Oncel D ，Emamverdi M ，Almidani L ，Farahani A ，Wakatsuki Y ，He Y ，Saju M S ，Lee WK ，Wykoff CC ，Sarraf D ，Freund KB ，Sadda SR ... -  《-》