Association between Retinal Morphology and Visual Functions in Eyes with Typical Neovascular Age Related Macular Degeneration: A Pilot Study
DOI:
https://doi.org/10.31584/jhsmr.20241068Keywords:
Malaysian eyes, neovascular age related macular degeneration, OCT parameters, visual componentsAbstract
Objective: The relationship between morphological and visual parameters in age-related macular degeneration may reveal markers for diagnosis and management of this disease. However, there is an insignificant paucity of research reporting any strong correlation between visual and morphological components of typical neovascular age-related macular degeneration (nAMD). Hence, the objectives of the present pilot research were to assess detailed visual components and various optical coherence tomography (OCT) parameters in eyes with typical nAMD, and to determine the association between them.
Material and Methods: Patients identified as naïve nAMD were recruited from a public hospital in Malaysia. Distance visual acuity (DVA), near visual acuity (NVA), reading speed (RS) and contrast sensitivity (CS) were assessed. Several quantitative and qualitative morphological parameters were evaluated, using the spectral-domain OCT.
Results: Fifteen newly diagnosed Typical nAMD eyes were examined. Mean (±standard deviation) DVA, NVA, CS and RS were recorded as: 0.92±0.39, 0.80±0.38, 0.75±0.39, 70.02±14, respectively. Average retinal thickness, central thickness and centre maximum thickness demonstrated good correlation (r≥0.05 with BCVA, NVA and CS. Similarly, the Centre minimum thickness demonstrated a good correlation (r≥0.50) with DVA. An intact external limiting membrane and photoreceptors inner and outer segment showed better visual components.
Conclusion: This present pilot study reported visual components and OCT parameters of Malaysian eyes with Typical nAMD, with some of the OCT parameters showing good correlation with visual components. Thus, regardless of its small sample size, this present pilot study generated new knowledge and understanding in this area. Future research with a larger sample is recommended.
References
Coleman HR, Chan C, Ferris III FL, Chew EY. Age-related macular degeneration. Lancet 2008;372:1835–45.
The Royal College of Ophthalmologists. Age-related macular degeneration: guidelines for management. London: The Royal College of Ophthalmologists; 2013.
Maruko I, Iida T, Saito M, Nagayama D, Saito K. Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 2007;144:15-22.
Takahashi K, Ishibashi T, Ogur Y, Yuzawa M. Working group for establishing diagnostic criteria for age-related macular degeneration. Nippon Ganka Gakkai Zasshi 2008;112:1076-84.
Yoshida Y, Kohno T, Yamamoto M, Yoneda T, Iwami H, Shiraki K. Two-year results of reduced-fluence photodynamic therapy combined with intravitreal ranibizumab for typical age-related macular degeneration and polypoidal choroidal vasculopathy. Jpn J Ophthalmol 2013;57:283-93.
Hata M, Tsujikawa A, Miyake M, Yamashiro K, Ooto S, Oishi A, et al. Two-year visual outcome of ranibizumab in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 2015;253:221-7.
Sharanjeet-Kaur S, Ghoshal R, Fadzil N, Ghosh S, Aziz RABA, Ngah NF. Visual functions and retinal morphology in patients with polypoidal choroidal vasculopathy seen in an age-related macular degeneration referral centre of Malaysia. Malays J Public Health Med 2018;1:124–34.
Lim LS, Cheung CM, Wong TY. Asian age-related macular degeneration: current concepts and gaps in knowledge. Asia Pac J Ophthalmol 2013;2:32-41.
Ghoshal R, Sharanjeet-Kaur S, Fadzil N, Ghosh S, Ngah NF, Aziz RABA. Quality of life in patients with neovascularage related macular degeneration (n-AMD) seen in a public hospital of Malaysia. Sains Malays 2018;47:2447–54.
Keane PA, Liakopoulos S, Chang KT, Wang M, Dustin L, Walsh AC, et al. Relationship between optical coherence tomography retinal parameters and visual acuity in neovascular age-related macular degeneration. Ophthalmology 2008;115:2206–14.
Moutray T, Alarbi M, Mahon G, Stevenson M, Chakravarthy U. Relationships between clinical measures of visual function, fluorescein angiographic and optical coherence tomography features in patients with sub foveal choroidal neovascularisation. Br J Ophthalmol 2008;92:361-4.
Henschel A, Spital G, Lommatzsch A, Pauleikhoff D. Opticalcoherence tomography in neovascular age related macular degeneration compared to fluorescein angiography and visual acuity. Eur J Ophthalmol 2009;19:831–5.
Kashani AH, Keane PA, Dustin L, Walsh AC, Sadda SR. Quantitative sub analysis of cystoid spaces and outer nuclear layer using optical coherence tomography in age-related macular degeneration. Invest. Ophthalmol Vis Sci 2009;50: 3366–73.
Keane PA, Patel PJ, Ouyang Y, Chen FK, Ikeji F, Walsh AC, et al. Effects of retinal morphology on CS and reading ability in neovascular age-related macular degeneration. Investig Ophthalmol Vis Sci 2010;51:5431-7.
Pauleikhoff D, Gunnemann ML, Ziegler M, Heimes-Bussmann B, Bormann E, Bachmeier I, et al. Morphological changes of macular neovascularization during long-term anti-VEGFtherapy in neovascular age-related macular degeneration. PloS One 2023;18:e0288861.
Buari NH, Chen AH, Musa N. Comparison of RS with 3 different log-scaled reading charts. J Optom 2014;7:210-6. doi: 10.1016/ j.optom.2013.12.009.
Pelli DG, Robson JG, Wilkins AJ. The design of a new letter chart for measuring CS. Clin Vis Sci 1988;2:187–99.
Ghoshal R, Sharanjeet-Kaur S, Mohamad Fadzil N, Mutalib HA, Ghosh S, Ngah NF, et al. Correlation between visual functions and retinal morphology in eyes with early and intermediate age-related macular degeneration. Int J Environ Res Public Health 2020;17:6379.
Ghoshal R, Sharanjeet-Kaur S, Mohamad Fadzil N, Mutalib HA, Ghosh S, Ngah NF, et al. Visual parameters and retinal morphology for polypoidal choroidal vasculopathy pre- and post-intravitreal ranibizumab with or without photodynamic therapy: a short-term prospective study. Int J Environ Res Public Health 2021;18:2581.
Cheung CMG, Li X, Mathur R, Lee SY, Chan CM, Yeo I, et al. A prospective study of treatment patterns and 1-year outcome of asian age-related macular degeneration and polypoidal choroidal vasculopathy. PLoS One 2014;9:e101057.
Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 2003; 121:1392–6.
Ng B, Kolli H, Ajith KN, Azzopardi M, Logeswaran A, Buensalido J, et al. Real-world data on faricimab switching in treatmentrefractory neovascular age-related macular degeneration. Life 2024;14:193.
Mäntyjärvi M, Laitinen T. Normal values for the Pelli-Robson CS test. J Cataract Refract Surg 2001;27:261–6.
Peterson CL, Yap CL, Tan TF, Tan LY, Sim KT, Ong L, et al. Monocular and binocular visual function assessments and activities of daily living performance in age-related macular degeneration. Ophthalmology Retina 2024;8:32–41.
Krebs I, Binder S, Stolba U, Schmid K, Glittenberg C, Brannath W, et al. Optical coherence tomography guided retreatment of photodynamic therapy. Br J Ophthalmol 2005;89:1184-7.
Hogg RE, Chakravarthy U. Visual function and dysfunction in early and late age-related maculopathy. Prog Retin Eye Res 2006;25:249–76.
Falkenstein IA, Cochran DE, Azen SP, Dustin L, Tammewar AM, Kozak I, et al. Comparison of visual acuity in macular degeneration patients measured with Snellen and Early Treatment Diabetic Retinopathy Study charts. Ophthalmology 2008;115:319-23.
Roberts P, Mittermueller TJ, Montuoro A, Sulzbacher F, Munk M, Sacuet S, et al. A quantitative approach to identify morphological features relevant for visual function in ranibizumab therapy of neovascular AMD. Invest Ophthalmol Vis Sci 2014;55:6623-30.
Fang M, Chanwimol K, Maram J, Datoo O’Keefe GA, Wykoff CC, Sarraf D, et al. Morphological characteristics of eyes with neovascular age-related macular degeneration and good longterm visual outcomes after anti-VEGF therapy. Br J Ophthalmol 2023;107:399–405.
Spaide RF, Curcio CA. Anatomical correlates to the bands seen in the outer retina by optical coherence tomography: literature review and model. Retina 2011;31:1609-19.
Newman E, Reichenbach A. The Müller cell: a functional element of the retina. Trends Neurosci 1996;19:307-12.
Saxena S, Srivastav K, Cheung CM, Ng JYW, Lai TTY. Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography. Clin Ophthalmol 2014; 8:2507-22.
Narayan DS, Chidlow G, Wood JP, Casson RJ. Glucose metabolism in mammalian photoreceptor inner and outer segments. Clin Exp Ophthalmol 2017;45:730–741. doi: 10.1111/ceo.12952.
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