Maximilian Pfau1,2, Philipp L Müller1,3, Leon von der Emde1, Moritz Lindner1,4, Philipp T Möller1,2, Monika Fleckenstein1,2, Frank G Holz1,2, Steffen Schmitz-Valckenberg1,2. 1. Department of Ophthalmology, University of Bonn, Bonn, Germany. 2. GRADE Reading Center, University of Bonn, Bonn, Germany. 3. Center for Rare Diseases, University of Bonn, Bonn, Germany; and. 4. The Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, Nuffield University of Oxford, Oxford, United Kingdom.
Abstract
PURPOSE: To investigate retinal sensitivity in the junctional zone of geographic atrophy (GA) secondary to age-related macular degeneration using patient-tailored perimetry grids for mesopic and dark-adapted two-color fundus-controlled perimetry. METHODS: Twenty-five eyes with GA of 25 patients (prospective, natural-history Directional Spread in Geographic Atrophy study [DSGA; NCT02051998]) and 40 eyes of 40 normal subjects were included. Patient-tailored perimetry grids were generated using annotated fundus autofluorescence data. Customized software positioned test-points along iso-hulls surrounding the GA boundary at distances of 0.43°, 0.86°, 1.29°, 2.15°, and 3.01°. The grids were used for duplicate mesopic and dark-adapted two-color (cyan and red) fundus-controlled perimetry. Age-adjusted reference-data were obtained through regression analysis of normative data followed by spatial interpolation. RESULTS: The mean sensitivity loss for mesopic testing decreased with the distance to GA (-10.3 dB [0.43°], -8.2 dB [0.86°], -7.1 dB [1.29°], -6.8 dB [2.15°], and -6.6 dB [3.01°]; P < 0.01). Dark-adapted cyan sensitivity loss exceeded dark-adapted red sensitivity loss for all iso-hulls (-14.8 vs. -11.7 dB, -13.5 vs. -10.1 dB, -12.8 vs. -9.1 dB, -11.6 vs. -8.2 dB, -10.7 vs. -8.0 dB; P < 0.01). CONCLUSION: Patient-tailored fundus-controlled perimetry grids allowed for testing of retinal function in the junctional zone of GA with high spatial resolution. A distinct decrease in mesopic sensitivity loss between 0.43° (125 µm) and 1.29° (375 µm) was observed that leveled off at more distant test-points. In proximity to the GA boundary, the results indicate that rod exceeded cone dysfunction.
PURPOSE: To investigate retinal sensitivity in the junctional zone of geographic atrophy (GA) secondary to age-related macular degeneration using patient-tailored perimetry grids for mesopic and dark-adapted two-color fundus-controlled perimetry. METHODS: Twenty-five eyes with GA of 25 patients (prospective, natural-history Directional Spread in Geographic Atrophy study [DSGA; NCT02051998]) and 40 eyes of 40 normal subjects were included. Patient-tailored perimetry grids were generated using annotated fundus autofluorescence data. Customized software positioned test-points along iso-hulls surrounding the GA boundary at distances of 0.43°, 0.86°, 1.29°, 2.15°, and 3.01°. The grids were used for duplicate mesopic and dark-adapted two-color (cyan and red) fundus-controlled perimetry. Age-adjusted reference-data were obtained through regression analysis of normative data followed by spatial interpolation. RESULTS: The mean sensitivity loss for mesopic testing decreased with the distance to GA (-10.3 dB [0.43°], -8.2 dB [0.86°], -7.1 dB [1.29°], -6.8 dB [2.15°], and -6.6 dB [3.01°]; P < 0.01). Dark-adapted cyan sensitivity loss exceeded dark-adapted red sensitivity loss for all iso-hulls (-14.8 vs. -11.7 dB, -13.5 vs. -10.1 dB, -12.8 vs. -9.1 dB, -11.6 vs. -8.2 dB, -10.7 vs. -8.0 dB; P < 0.01). CONCLUSION:Patient-tailored fundus-controlled perimetry grids allowed for testing of retinal function in the junctional zone of GA with high spatial resolution. A distinct decrease in mesopic sensitivity loss between 0.43° (125 µm) and 1.29° (375 µm) was observed that leveled off at more distant test-points. In proximity to the GA boundary, the results indicate that rod exceeded cone dysfunction.
Authors: Diane L Wang; Julia Agee; Marco Mazzola; Riccardo Sacconi; Giuseppe Querques; Alan D Weinberg; R Theodore Smith Journal: Ophthalmol Retina Date: 2019-08-07
Authors: Maximilian Pfau; Guenther Walther; Leon von der Emde; Philipp Berens; Livia Faes; Monika Fleckenstein; Tjebo F C Heeren; Karsten Kortüm; Sandrine H Künzel; Philipp L Müller; Peter M Maloca; Sebastian M Waldstein; Maximilian W M Wintergerst; Steffen Schmitz-Valckenberg; Robert P Finger; Frank G Holz Journal: Ophthalmologe Date: 2020-10 Impact factor: 1.059
Authors: Kristina Hess; Martin Gliem; Peter Charbel Issa; Johannes Birtel; Philipp L Müller; Leon von der Emde; Philipp Herrmann; Frank G Holz; Maximilian Pfau Journal: JAMA Ophthalmol Date: 2020-12-01 Impact factor: 7.389
Authors: Maximilian Pfau; Leon von der Emde; Luis de Sisternes; Joelle A Hallak; Theodore Leng; Steffen Schmitz-Valckenberg; Frank G Holz; Monika Fleckenstein; Daniel L Rubin Journal: JAMA Ophthalmol Date: 2020-10-01 Impact factor: 7.389
Authors: Leon von der Emde; Maximilian Pfau; Sarah Thiele; Philipp T Möller; Ruth Hassenrik; Monika Fleckenstein; Frank G Holz; Steffen Schmitz-Valckenberg Journal: Transl Vis Sci Technol Date: 2018-01-09 Impact factor: 3.283
Authors: Jason Charng; Tina M Lamey; Jennifer A Thompson; Terri L McLaren; Mary S Attia; Ian L McAllister; Ian J Constable; David A Mackey; John N De Roach; Fred K Chen Journal: Transl Vis Sci Technol Date: 2020-09-09 Impact factor: 3.283