Clinical Utility of Morphofunctional Correlation of Microperimetry and Optical Coherence Tomography

Abstract

Purpose: To demonstrate the clinical and research value of a simplified technique enabling alignment of functional microperimetry data with retinal structure imaged by eyetracked optical coherence tomography (OCT) in eyes with macular disease.Methods: Normal and diseased eyes underwent sequential Spectralis OCT macular raster scans and Macular Integrity Assessment microperimetry using both standard central 10°analysis and custom scan patterns. The microperimetry data were imported into Spectralis research software program, which was automatically registered to the scanning laser ophthalmoscopy near-infrared reflectance image obtained during OCT acquisition. The OCT B-scans were directly correlated with the microperimetry data so that retina sensitivity and retinal microstructure at corresponding points could be evaluated simultaneously.Results: Seventy eyes of 41 patients (110 studies) aged 22 years to 95 years (mean 63.5 ± 18.0 years) with both normal and pathologic macular changes were included. The mean Macular Integrity Assessment retina sensitivity of all 110 studies was 22.2 ± 4.9 (range: 0.1-30.3). Retinal sensitivity showed good correspondence in structural changes seen on OCT B-scans. Conclusion:We demonstrate a practical method to align retina sensitivity data to anatomical tomographic findings. This technique provides data not obtainable with standard visual acuity measures.

Retinal Sensitivity Correlates With the Superficial Vessel Density and Inner Layer Thickness in Diabetic Retinopathy

“…These focal areas of decreased retinal sensitivity have been recently described in one case of NPDR in areas of attenuated inner retinal layers on OCT but without loss of outer retinal structures. 43 In patients with diabetes, Montesano et al have described a significant correlation between the retinal sensitivity and the GCL-IPL thickness in diabetic eyes without DR. This suggests that the presence of inner retinal layer damage could deteriorate the visual function even before the appearance of any sign of vascular alterations.…”

Multiscale Correlation of Microvascular Changes on Optical Coherence Tomography Angiography With Retinal Sensitivity in Diabetic Retinopathy

“…25 Using microperimetry and OCT and/or FA, the reduction of retinal sensitivity with increasing DR severity has been well documented in conjunction with various morphologic features of DR including diabetic macular edema, reduced ganglion cell complex thickness, hard exudates, and capillary nonperfusion. [26][27][28][29][30][31][32][33][34][35][36][37] There are several recent studies comparing OCTA metrics with retinal sensitivity measured by microperimetry in diabetic retinopathy. [38][39][40][41] Although these studies report a positive association between OCTA parameters related to retinal ischemia (such as reduced vessel density and increased areas of capillary nonperfusion) and reduced MP sensitivity in DR, these comparisons have been predominantly qualitative.…”

“…25 Using microperimetry and OCT and/or FA, the reduction of retinal sensitivity with increasing DR severity has been well documented in conjunction with various morphologic features of DR including diabetic macular edema, reduced ganglion cell complex thickness, hard exudates, and capillary nonperfusion. 26–37…”