Retinal status in moderate myopia and age-related macular degeneration. Management strategies

Abstract

Aim: to assess retinal status in comorbid ocular disorders (moderate myopia and age-related macular degeneration/AMD of various stages) using modern diagnostic tools. Patients and Methods: 48 patients (96 eyes) with moderate myopia and dry AMD were enrolled. Best-corrected visual acuity (BCVA), mean deviation/MD (characterizes mean reduction of sensitivity), pattern standard deviation/PSD (characterizes the severity of local visual field defects), central macular thickness (CMT), and axial length (AL) were measured. The macular zone was investigated by optical coherence tomography (OCT) using B scan and fundus autofluorescence (FAF) regimens. Results: in moderate myopia associated with dry AMD (AREDS categories 1,2,3), a significant reduction in the mean BCVA (20/25) was detected in 54.2% (26 patients, 52 eyes). Retinal photosensitivity indices (MD and PSD) were also significantly reduced to 2.19 dB (р<0.001) and 2.14 dB (р<0.001), respectively. AL was significantly increased (25.11 mm, р<0.001). No significant differences in CMT values were revealed (233 mcm, p=0.123). In comorbid ocular disorders, severe defects and focuses of RPE atrophy, extensive areas of the IS/OS junction line damage, and drusen are seen among morphological abnormalities of the eye fundus. FAF identified certain pathological patterns, e.g., focal hypo- and hyperautofluorescence, hyperautofluorescent halo at the border of staphyloma, linear hypoautofluorescent bands surrounded with hyperautofluorescence, reticular pattern, patches, focal and multifocal areas of geographic atrophy. Conclusion: our findings on visual field loss (MD, PSD) in AMD depending on stage and OCT findings in AMD are in line with the results of other authors. Meanwhile, we investigated a comorbid variant (AMD in association with moderate myopia), compared morphological and functional parameters, and addressed the relevance of FAF. Keywords: myopia, age-related macular degeneration, optical coherence tomography, autofluorescence. For citation: Moshetova L.K., Alekseev I.B., Vorob’eva I.V., Nam Yu.A. Retinal status in moderate myopia and age-related macular degeneration. Management strategies. Russian Journal of Clinical Ophthalmology. 2022;22(2):91–98 (in Russ.). DOI: 10.32364/2311- 7729-2022-22-2-91-98.