Hypertransmission and Vision in Aging and Age-Related Macular Degeneration: Longitudinal Data From ALSTAR2

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-08-21 DOI:10.1016/j.ajo.2025.08.038

Will Johnston , Sarah S. Kim , Deepayan Kar , Liyan Gao , Mark E. Clark , Gerald McGwin Jr. , Kenneth R. Sloan , Cynthia Owsley , Christine A. Curcio , Lukas Goerdt

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引用次数: 0

Abstract

Purpose

To investigate the presence of hypertransmission (HT) in normal aging, early (e)AMD, and intermediate (i)AMD, changes over 3 years, and the impact of HTs ≥ 250 µm (LHyperTD) on 7 tests of scotopic, mesopic, and photopic vision.

Design

Prospective cohort study.

Subjects

Participants of the Alabama Study on Early Age-Related Macular Degeneration 2.

Methods

ALSTAR2 participants underwent spectral domain optical coherence tomography angiography (OCTA), color fundus photography, and vision testing at baseline and 3-year follow-up. HT presence and stepped diameters in choroidal en face slabs were assessed with custom review software. Only LHyperTD were analyzed at follow-up. AMD was staged via AREDS 9-step. Vision at baseline and follow-up between eyes with and without LHyperTD was analyzed with linear regression.

Main outcome measures

Presence, size, and illustrative examples of HT, association with tests of photopic, mesopic and scotopic vision.

Results

Baseline data was available on 460 eyes of 460 patients (mean age 71.5 ± 5.7 years, 277 female; 236 normal, 134 eAMD, 90 iAMD). HT of any size were found in iAMD (86.7%), eAMD (35.1%), and normal (3.8%) eyes, with proportional LHyperTD (13.3% vs 4.2% vs 0.4%, P < .01). For 339 eyes (mean age 71.2 ± 5.8 years, 206 female, 181 normal, 92 eAMD, 66 iAMD), LHyperTD presence significantly increased in normal (P = .01) and iAMD (P < .01) but not in eAMD eyes. At baseline, photopic contrast sensitivity (CS), mesopic CS, and rod intercept time (for rod mediated dark adaptation, RMDA) were worse in eyes with LHyperTD compared to eyes without (all P < .01). At follow-up, the same were worse in LHyperTD (all P < .01), as well as low luminance visual acuity (P < .01) and scotopic light sensitivity (P = .05).

Conclusion

LHyperTD are rare in normal and eAMD eyes and associate with mesopic and scotopic visual functions in addition to risk-indicating RMDA. Delayed RMDA reflects other factors other than LHyperTD including differences in disease stage. Our analysis of HT < 250 µm may inform other studies of early disease. LHyperTD are best utilized as imaging biomarkers for later stages of iAMD than ALSTAR2.

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衰老和年龄相关性黄斑变性的超传输和视力：来自ALSTAR2的纵向数据

研究超透射（HT）在正常衰老、早期(e)型AMD和中期(i)型AMD中的存在，3年内的变化，以及HTs≥250µm （LHyperTD）对暗视、中视和光视7项测试的影响。

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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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.