Inês Laíns1, John B Miller2, Dong H Park3, Edem Tsikata4, Samaneh Davoudi2, Safa Rahmani2, Jonathan Pierce2, Rufino Silva5, Teresa C Chen4, Ivana K Kim2, Demetrios Vavvas2, Joan W Miller2, Deeba Husain6. 1. Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, AIBILI, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 2. Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. 3. Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, School of Medicine, Kyungpook National University, South Korea. 4. Glaucoma Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. 5. Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, AIBILI, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 6. Retina Service, Massachusetts Eye and Ear, Harvard Ophthalmology AMD Center of Excellence, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: Deeba_Husain@meei.harvard.edu.
Abstract
PURPOSE: To examine the relationship between dark adaptation (DA) and optical coherence tomography (OCT)-based macular morphology in age-related macular degeneration (AMD). DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Patients with AMD and a comparison group (>50 years) without any vitreoretinal disease. METHODS: All participants were imaged with spectral-domain OCT and color fundus photographs, and then staged for AMD (Age-related Eye Disease Study system). Both eyes were tested with the AdaptDx (MacuLogix, Middletown, PA) DA extended protocol (20 minutes). A software program was developed to map the DA testing spot (2° circle, 5° superior to the fovea) to the OCT B-scans. Two independent graders evaluated the B-scans within this testing spot, as well as the entire macula, recording the presence of several AMD-associated abnormalities. Multilevel mixed-effects models (accounting for correlated outcomes between 2 eyes) were used for analyses. MAIN OUTCOME MEASURES: The primary outcome was rod-intercept time (RIT), defined in minutes, as a continuous variable. For subjects unable to reach RIT within the 20 minutes of testing, the value of 20 was assigned. RESULTS: We included 137 eyes (n = 77 subjects), 72.3% (n = 99 eyes) with AMD and the remainder belonging to the comparison group. Multivariable analysis revealed that even after adjusting for age and AMD stage, the presence of any abnormalities within the DA testing spot (ß = 4.8, P < 0.001), as well as any abnormalities in the macula (ß = 2.4, P = 0.047), were significantly associated with delayed RITs and therefore impaired DA. In eyes with no structural changes within the DA testing spot (n = 76, 55.5%), the presence of any abnormalities in the remaining macula was still associated with delayed RITs (ß = 2.00, P = 0.046). Presence of subretinal drusenoid deposits and ellipsoid zone disruption were a consistent predictor of RIT, whether located within the DA testing spot (P = 0.001 for both) or anywhere in the macula (P < 0.001 for both). Within the testing spot, the presence of classic drusen or serous pigment epithelium detachment was also significantly associated with impairments in DA (P ≤ 0.018). CONCLUSIONS: Our results suggest a significant association between macular morphology evaluated by OCT and time to dark-adapt. Subretinal drusenoid deposits and ellipsoid zone changes seem to be strongly associated with impaired dark adaptation.
PURPOSE: To examine the relationship between dark adaptation (DA) and optical coherence tomography (OCT)-based macular morphology in age-related macular degeneration (AMD). DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Patients with AMD and a comparison group (>50 years) without any vitreoretinal disease. METHODS: All participants were imaged with spectral-domain OCT and color fundus photographs, and then staged for AMD (Age-related Eye Disease Study system). Both eyes were tested with the AdaptDx (MacuLogix, Middletown, PA) DA extended protocol (20 minutes). A software program was developed to map the DA testing spot (2° circle, 5° superior to the fovea) to the OCT B-scans. Two independent graders evaluated the B-scans within this testing spot, as well as the entire macula, recording the presence of several AMD-associated abnormalities. Multilevel mixed-effects models (accounting for correlated outcomes between 2 eyes) were used for analyses. MAIN OUTCOME MEASURES: The primary outcome was rod-intercept time (RIT), defined in minutes, as a continuous variable. For subjects unable to reach RIT within the 20 minutes of testing, the value of 20 was assigned. RESULTS: We included 137 eyes (n = 77 subjects), 72.3% (n = 99 eyes) with AMD and the remainder belonging to the comparison group. Multivariable analysis revealed that even after adjusting for age and AMD stage, the presence of any abnormalities within the DA testing spot (ß = 4.8, P < 0.001), as well as any abnormalities in the macula (ß = 2.4, P = 0.047), were significantly associated with delayed RITs and therefore impaired DA. In eyes with no structural changes within the DA testing spot (n = 76, 55.5%), the presence of any abnormalities in the remaining macula was still associated with delayed RITs (ß = 2.00, P = 0.046). Presence of subretinal drusenoid deposits and ellipsoid zone disruption were a consistent predictor of RIT, whether located within the DA testing spot (P = 0.001 for both) or anywhere in the macula (P < 0.001 for both). Within the testing spot, the presence of classic drusen or serous pigment epithelium detachment was also significantly associated with impairments in DA (P ≤ 0.018). CONCLUSIONS: Our results suggest a significant association between macular morphology evaluated by OCT and time to dark-adapt. Subretinal drusenoid deposits and ellipsoid zone changes seem to be strongly associated with impaired dark adaptation.
Authors: Merina Thomas; Rebecca F Silverman; Filippos Vingopoulos; Megan Kasetty; Gina Yu; Esther L Kim; Amro A Omari; Katherine A Joltikov; Eun Y Choi; Leo A Kim; David N Zacks; John B Miller Journal: J Vitreoretin Dis Date: 2020-11-05
Authors: Anna V Zarubina; Carrie E Huisingh; Mark E Clark; Kenneth R Sloan; Gerald McGwin; Jason N Crosson; Christine A Curcio; Cynthia Owsley Journal: Curr Eye Res Date: 2018-05-01 Impact factor: 2.424
Authors: Robert F Mullins; Gerald McGwin; Karen Searcey; Mark E Clark; Elizabeth L Kennedy; Christine A Curcio; Edwin M Stone; Cynthia Owsley Journal: Ophthalmology Date: 2018-10-31 Impact factor: 12.079
Authors: Ines Lains; Shrinivas J Pundlik; Archana Nigalye; Raviv Katz; Gang Luo; Ivana K Kim; Demetrios G Vavvas; Joan W Miller; John B Miller; Deeba Husain Journal: Retina Date: 2021-10-01 Impact factor: 3.975
Authors: Walter H Moos; Douglas V Faller; Ioannis P Glavas; David N Harpp; Michael H Irwin; Iphigenia Kanara; Carl A Pinkert; Whitney R Powers; Kosta Steliou; Demetrios G Vavvas; Krishna Kodukula Journal: Biores Open Access Date: 2017-12-01
Authors: Miin Roh; Hyun Joon Shin; Inês Laíns; Joana Providência; Maria Caseiro-Alves; Patrícia Barreto; Demetrios G Vavvas; John B Miller; Ivana K Kim; John Michael Gaziano; Liming Liang; Rufino Silva; Joan W Miller; Deeba Husain Journal: Invest Ophthalmol Vis Sci Date: 2020-02-07 Impact factor: 4.799