Ophthalmology Unit, "Sapienza" University of Rome, NESMOS Department, St. Andrea Hospital, Rome, Italy.
IRCCS Fondazione Bietti, Rome, Italy.
Invest Ophthalmol Vis Sci. 2022 Mar 2;63(3):16. doi: 10.1167/iovs.63.3.16.
To assess the effect of drusen morphometric changes and choroidal vascular modifications on retinal sensitivity (RS) evaluated through microperimetry in intermediate age-related macular degeneration (iAMD).
A retrospective review of 18 iAMD patients (18 eyes) with a 12-month follow-up was performed. Eye-tracked spectral-domain optical coherence tomography was obtained, with automatic segmentation of the outer retinal layer (ORL) delineating the drusen area from the external limiting membrane to Bruch's membrane and outer nuclear layer (ONL) thickness maps adjusted manually, as needed. Advanced retinal pigment epithelium analysis was also performed with a ZEISS PLEX Elite 900. Microperimetry obtained under mesopic conditions was overlaid with the corresponding thickness maps with Fiji software. The choroidal vascularity index (CVI) was calculated in the subfoveal b-scan and volumetric in the central 1-mm subfield.
A reduced central ONL thickness was strongly associated with RS decline at the same region (r = 0.69, P = 0.002) and globally (r = 0.80, P < 0.001) at baseline, but also at 1 year in the central subfield (central: r = 0.70, P = 0.001). One-year subfoveal CVI variation, differently from volumetric CVI, directly influenced the central (r = 0.64, P = 0.004) and global RS (r = 0.59, P = 0.009), indicating that a CVI reduction negatively affected RS. A greater volumetric CVI within central 1-mm was associated with ORL thickening at 1 year (r = 0.61, P = 0.008).
Progressive degeneration of the ONL is related to irreversible photoreceptor dysfunction in iAMD. Likewise, choroidal vascular modifications are associated with a significant functional decline in the central region and diffusely.
评估在中间型年龄相关性黄斑变性（iAMD）中，通过微视野计评估的视网膜敏感性（RS）与玻璃膜疣形态计量学变化和脉络膜血管变化的关系。
回顾性分析了 18 例 iAMD 患者（18 只眼）的资料，这些患者在 12 个月的随访中进行了眼跟踪谱域光相干断层扫描，自动对视网膜外核层（ONL）进行分段，从外节膜到 Bruch 膜勾画玻璃膜疣区域，并手动调整 ONL 厚度图，如有需要。还使用 ZEISS PLEX Elite 900 进行高级视网膜色素上皮分析。在中光条件下获得的微视野检查结果与 Fiji 软件中的相应厚度图重叠。在中心 1mm 子区域中计算脉络膜血管指数（CVI）的亚区。
在基线时，中央 ONL 厚度的减少与同一区域（r = 0.69，P = 0.002）和全局（r = 0.80，P < 0.001）的 RS 下降强烈相关，但在中央子区域的 1 年时也是如此（中央：r = 0.70，P = 0.001）。与体积 CVI 不同，一年时的中心下 CVI 变化直接影响中央（r = 0.64，P = 0.004）和全局 RS（r = 0.59，P = 0.009），表明 CVI 减少对 RS 有负面影响。中央 1mm 内的更大体积 CVI 与一年时的 ORL 增厚相关（r = 0.61，P = 0.008）。
ONL 的进行性变性与 iAMD 中不可逆转的光感受器功能障碍有关。同样，脉络膜血管变化与中央区域和弥漫性的显著功能下降相关。
