Birner Klaudia, Coulibaly Leonard M, Schrittwieser Johannes, Steiner Irene, Mohamed Hamza, Schürer-Waldheim Simon, Gumpinger Markus, Bogunovic Hrvoje, Schmidt-Erfurth Ursula, Reiter Gregor S
Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria.
Acta Ophthalmol. 2025 Jun;103(4):423-431. doi: 10.1111/aos.17434. Epub 2024 Dec 27.
The relationship between retinal morphology, as assessed by optical coherence tomography (OCT), and retinal function in microperimetry (MP) has not been well studied, despite its increasing importance as an essential functional endpoint for clinical trials and emerging therapies in retinal diseases. Normative databases of healthy ageing eyes are largely missing from literature.
Healthy subjects above 50 years were examined using two MP devices, MP-3 (NIDEK) and MAIA (iCare). An identical grid, encompassing 45 stimuli was used for retinal sensitivity (RS) assessment. Deep-learning-based algorithms performed automated segmentation of ellipsoid zone (EZ), outer nuclear layer (ONL), ganglion cell layer (GCL) and retinal nerve fibre layer (RNFL) from OCT volumes (Spectralis, Heidelberg). Pointwise co-registration between each MP stimulus and corresponding location on OCT was performed via registration algorithm. Effect of age, eccentricity and layer thickness on RS was assessed by mixed effect models.
Three thousand six hundred stimuli from twenty eyes of twenty patients were included. Mean patient age was 68.9 ± 10.9 years. Mean RS for the first exam was 28.65 ± 2.49 dB and 25.5 ± 2.81 dB for MP-3 and MAIA, respectively. Increased EZ thickness, ONL thickness and GCL thickness were significantly correlated with increased RS (all p < 0.001). Univariate models showed lower RS with advanced age and higher eccentricity (both p < 0.05).
This work provides reference values for healthy age-related EZ and ONL-thicknesses without impairment of visual function and evidence for RS decrease with eccentricity and increasing age. This information is crucial for interpretation of future clinical trials in disease.
尽管光学相干断层扫描（OCT）评估的视网膜形态与微视野计（MP）中的视网膜功能之间的关系作为视网膜疾病临床试验和新兴疗法的重要功能终点，其重要性日益增加，但尚未得到充分研究。文献中很大程度上缺少健康老龄眼睛的标准数据库。
使用两种MP设备，即MP-3（尼德克）和MAIA（iCare）对50岁以上的健康受试者进行检查。使用包含45个刺激点的相同网格来评估视网膜敏感度（RS）。基于深度学习的算法对OCT容积（Spectralis，海德堡）中的椭圆体带（EZ）、外核层（ONL）、神经节细胞层（GCL）和视网膜神经纤维层（RNFL）进行自动分割。通过配准算法在每个MP刺激点与OCT上的相应位置之间进行逐点配准。通过混合效应模型评估年龄、偏心度和层厚度对RS的影响。
纳入了20名患者20只眼睛的3600个刺激点。患者平均年龄为68.9±10.9岁。第一次检查时，MP-3和MAIA的平均RS分别为28.65±2.49 dB和25.5±2.81 dB。EZ厚度、ONL厚度和GCL厚度增加与RS增加显著相关（所有p<0.001）。单变量模型显示，年龄增长和偏心度增加时RS较低（均p<0.05）。
这项工作提供了与年龄相关的健康EZ和ONL厚度的参考值，且视觉功能无损害，并提供了RS随偏心度和年龄增加而降低的证据。这些信息对于解释未来疾病的临床试验至关重要。
