ISaR Projekt

"To study the association between peripheral changes in Age-related Macular Degeneration (AMD) and dark adaptation (DA). DESIGN: Prospective, cross-sectional study. METHODS: We recruited patients with AMD and a control group (> 50 years) without any vitreoretinal disease. Ultra-widefield (UWF) pseudocolor and fundus autofluorescence (FAF) (Optos Inc, MA) were obtained, and were assessed by two graders for the presence of several peripheral changes in perimacular, mid- and far-peripheral zones. All participants were also imaged with 7 field color fundus photographs used for AMD staging (AREDS system). Both eyes of study participants were tested with the AdaptDx® (MacuLogix, PA) DA extended protocol (20 minutes). Multilevel, mixed-effect models (accounting for correlated outcomes between 2 eyes) were used for analyses. RESULTS: We included 128 eyes (n= 72 patients), 75% with AMD and the remainder controls. The presence of reticular pigmentary changes in the mid- (ß= 4.3, p=0.012) and far- peripheral zones (ß= 8.4, p<0.001) was associated with delayed rod-intercept times (RITs), even after adjusting for confounding factors. The presence, number and extent of peripheral classic drusen did not show a similar association (p ≥ 0.148). The presence of a mottled decreased FAF pattern in the mid-peripheral zone was also associated with prolonged RITs (β= 4.4, p= 0.031). CONCLUSION: Our results suggest an association between DA and the presence of peripheral reticular pigmentary changes, as well as the presence of a peripheral mottled decreased FAF pattern. This provides new insights on the clinical significance of peripheral changes in AMD, and their contribution to impairments on DA."

(Zitat und Quelle: Harvard Medical School)