Exploiting Microperimetry as a Functional End Point in Healthy Aging and Different Stages of Age-Related Macular Degeneration

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-06-10 DOI:10.1016/j.xops.2025.100850

Johannes Schrittwieser MD , Klaudia Birner MD , Leonard M. Coulibaly MD , Ursula Schmidt-Erfurth MD , Gregor S. Reiter MD, PhD

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引用次数: 0

Abstract

Objective

To compare functional parameters between healthy aged eyes and different stages of age-related macular degeneration (AMD) based on functional parameters in microperimetry (MP) in 2 commonly used MP devices.

Design

A prospective, cross-sectional study.

Subjects

From 80 eyes from 80 subjects, 14 400 stimuli points were included.

Methods

Subjects classified as healthy, intermediate AMD, neovascular AMD (nAMD), or geographic atrophy (GA) secondary to AMD were imaged with Spectralis HRA+OCT (Heidelberg Engineering) and underwent 2 consecutive examinations each, using the MP-3 (NIDEK) under photopic conditions and the MAIA (Centervue) under mesopic conditions. Pointwise sensitivity (PWS), mean sensitivity, range between highest and lowest PWS, fixation stability, and examination duration were compared between all 4 groups in both devices. Group comparison was performed using linear mixed-effects models and a discriminant analysis to find the parameters that best discriminated the respective AMD stage.

Main Outcome Measures

Pointwise sensitivity, range of the PWS, fixation metrics, and durations of the examinations.

Results

The groups exhibited significant differences in PWS (P < 0.001) and mean sensitivity (P < 0.001), with healthy eyes showing the highest and late stages of AMD showing the lowest sensitivity values. In addition, GA showed significantly greater fixation stability compared with nAMD in the MP-3 at 2° and 4° (P = 0.014 and P = 0.008, respectively). The examination duration in healthy patients was significantly shorter compared with patients with GA (P = 0.041) in MP-3. No significant differences in fixation stability and duration between groups were observed with the MAIA device. The range between the highest and lowest PWS was the most effective parameter for discrimination, with a classification accuracy of 52.5% and 50.6% in the MP-3 and MAIA, respectively.

Conclusions

Retinal sensitivity declines with disease progression in AMD in both mesopic and photopic background illumination. The lowest retinal sensitivity was observed in patients with GA. Background illumination should be considered when selecting an MP device for a clinical trial.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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利用显微视野作为健康衰老和年龄相关性黄斑变性不同阶段的功能终点

目的通过两种常用的显微视力仪（MP）的功能参数，比较年龄相关性黄斑变性（AMD）不同阶段健康老年眼的功能参数。设计一项前瞻性、横断面研究。来自80名受试者的80只眼睛，包括14 400个刺激点。方法采用Spectralis HRA+OCT （Heidelberg Engineering）对健康、中度AMD、新生血管性AMD （nAMD）或继发于AMD的地理萎缩（GA）受试者进行成像，分别在光敏条件下使用MP-3 （NIDEK）和介观条件下使用MAIA （Centervue）进行2次连续检查。比较4组在两种设备上的点灵敏度（PWS）、平均灵敏度、最高和最低PWS之间的范围、固定稳定性和检查时间。使用线性混合效应模型和判别分析进行组间比较，以找到最能区分各自AMD阶段的参数。主要观察指标：灵敏度、PWS范围、固定指标和检查持续时间。结果两组患者PWS (P <；0.001)和平均灵敏度(P <；0.001)，健康眼睛的敏感性值最高，晚期AMD的敏感性值最低。此外，GA在MP-3 2°和4°处的固定稳定性显著高于nAMD （P = 0.014和P = 0.008）。健康患者MP-3检查时间明显短于GA患者（P = 0.041）。使用MAIA装置两组间固定稳定性和持续时间无显著差异。最高和最低PWS之间的范围是最有效的区分参数，MP-3和MAIA的分类准确率分别为52.5%和50.6%。结论在中观和光性背景光照下，AMD患者视网膜敏感性随疾病进展而下降。GA患者的视网膜敏感性最低。在为临床试验选择MP设备时应考虑背景照明。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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