Structure-Function Relationships in Geographic Atrophy Based on Mesopic Microperimetry, Fundus Autofluorescence, and Optical Coherence Tomography.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Translational Vision Science & Technology Pub Date : 2025-02-03 DOI:10.1167/tvst.14.2.7

Souvick Mukherjee, Thilaka Arunachalam, Cameron Duic, Maria Abraham, Christine Orndahl, Supriya Menezes, Elvira Agrón, Maximilian Pfau, Tharindu de Silva, Clare Bailey, Alisa T Thavikulwat, Sunil Bellur, SriniVas R Sadda, Emily Y Chew, Brett G Jeffrey, Wai T Wong, Tiarnan D L Keenan

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引用次数: 0

Abstract

Purpose: To examine relationships between retinal structure and visual function in geographic atrophy (GA) by analyzing spatial agreement between absolute scotomas and macular structure, focusing on (1) choroidal hypertransmission, a key feature of complete retinal pigment epithelium and outer retinal atrophy (cRORA), and (2) fundus autofluorescence (FAF)-defined GA.

Methods: Mesopic microperimetry (using a novel T-shaped pattern) and multimodal imaging were recorded longitudinally in a phase II GA trial. Horizontal and vertical optical coherence tomography (OCT) line scans (corresponding to the T axes) were graded for choroidal hypertransmission; FAF images were graded for GA. Spatial concordance between zones of absolute scotoma and atrophy was quantified by the Dice similarity coefficient (DSC).

Results: The analysis population comprised 24 participants (mean follow-up 26.8 months). For concordance between absolute scotoma and choroidal hypertransmission, estimated mean DSC was 0.70 (95% confidence interval [CI], 0.64-0.77). This was significantly higher than for FAF-defined GA (0.67; 95% CI, 0.61-0.74; estimated mean difference = 0.03, 95% CI, 0.02-0.05, P < 0.001). Mean OCT choroidal reflectivity was strongly associated with likelihood and severity of scotoma.

Conclusions: Spatial concordance between absolute scotomas and GA structural features is moderately high and slightly higher for choroidal hypertransmission than FAF-defined GA. This supports choroidal hypertransmission, a key cRORA feature, as an outcome measure in interventional trials. OCT provides more information to explain visual function than FAF alone. However, given some discordance for both structural features, performing microperimetry alongside imaging remains important.

Translational relevance: These findings provide insights into the complex relationship between retinal structure and visual function and contribute to a nuanced understanding of outcome measures.

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.