Macular Function in Early and Intermediate Age-related Macular Degeneration: Correlation with the Simplified Thea Risk Assessment Scale (STARS)

Minnella, Angelo Maria; Piccardi, Marco; Placidi, Giorgio; García‐Layana, Alfredo; Delcourt, Cécile; Valentini, Patrizia; Falsini, Benedetto

doi:10.1167/tvst.9.10.28

Cited by 3 publications

(7 citation statements)

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“…The results showed that microanatomic abnormalities of the macula were correlated with abnormalities in functional parameters (acuity, fERG), indicating early losses in retinal function. 13 , 21 In addition, the extent of RORA, a parameter correlated with visual acuity and fERG amplitude, significantly predicted the progression of disease at 12 months. Our findings support the diagnostic power and predictivity of morphofunctional assessments in ne-AMD eyes.…”

Section: Discussionmentioning

confidence: 96%

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Subretinal Pigment Epithelium Illumination Combined With Focal Electroretinogram and Visual Acuity for Early Diagnosis and Prognosis of Non-Exudative Age-Related Macular Degeneration: New Insights for Personalized Medicine

Savastano

Falsini

Ferrara

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose To evaluate the correlation between functional visual acuity and focal electroretinograms (fERGs) and morphological abnormalities in the retinal pigment epithelium and outer retinal atrophy (RORA) assessed by subretinal illumination (SRI) parameter at optical coherence tomography (OCT) examinations as signs of early disease in early and intermediate non-exudative age-related macular degeneration (ne-AMD). Methods One hundred forty-one eyes of 74 patients were retrospectively evaluated. A subgroup of patients (34/74) had a follow-up of at least 1 year. The study included both cross-sectional and longitudinal analyses. All eyes were assessed by OCT to measure the macular outer nuclear layer thickness, extent of ellipsoid zone interruption, absence or presence of drusen/reticular pseudodrusen in the foveal and perifoveal fields, and the SRI area closest to the fovea. Additionally, fERGs were performed. Results In the cross-sectional analysis, visual acuity and fERG amplitude were correlated ( P < 0.01) with the SRI area. The fERG amplitude was correlated ( P < 0.01) with the extent of ellipsoid zone interruption and tended to be lower in reticular pseudodrusen compared with drusen. In the longitudinal analysis, fERG amplitudes and outer retinal thickness tended to decrease on average by 15% and 18%, respectively, after 1 year of follow-up. The baseline RORA area, but not fERG amplitude or visual acuity, significantly predicted with 77% accuracy ( P < 0.01) morphological deterioration, which was determined by an increase in the RORA area after 1 year. Conclusions Functional visual acuity and its morphological correlations can be assessed in early and intermediate ne-AMD eyes. SRI, as a result of RORA, is a potential predictor of ne-AMD progression in a short-term follow-up. Translational Relevance SRI assessment, an objective method to measure RORA, is a potential biomarker for non-exudative AMD progression.

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Section: Discussionmentioning

confidence: 96%

“…11 , 14 In other studies, the combination of microperimetric sensitivity and low luminance deficit assessment have been reported as suboptimal in predicting the progression of disease. 21 …”

Section: Discussionmentioning

confidence: 99%

Subretinal Pigment Epithelium Illumination Combined With Focal Electroretinogram and Visual Acuity for Early Diagnosis and Prognosis of Non-Exudative Age-Related Macular Degeneration: New Insights for Personalized Medicine

Savastano

Falsini

Ferrara

et al. 2022

Trans. Vis. Sci. Tech.

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“…Correlations between the amplitude of FERG and ageing (Messenio et al 2013) as well as intermediate AMD have been reported (Falsini et al 1999(Falsini et al , 2000(Falsini et al , 2007; two recent works have correlated decline in FERG amplitude with subjective deterioration of vision quality (Minnella et al 2020) and to development of incomplete RPE and outer retinal atrophy (iRORA, Wu et al, 2021) in early and intermediate AMD patients (Savastano et al 2020). Interestingly, mean FERG amplitude of iAMD patients in Savastano et al was extremely close to that measured in our patients (mean amplitude: 1.1 µV versus 1.15 µV, respectively), possibly attesting for the reproducibility of FERG recording results.…”

Section: Discussionmentioning

confidence: 97%

“…Few studies have instead explored the performance of focal electroretinogram (FERG) in early and intermediate AMD (Seiple et al 1986;Falsini et al 2000Falsini et al , 2007Minnella et al 2020;Savastano et al 2020), and none has compared it to macular function testing through microperimetry.…”

Section: Discussionmentioning

confidence: 99%

Focal electroretinogram and microperimetry testing of photoreceptor‐retinal pigment epithelium function in intermediate age‐related macular degeneration

Messenio

Babbi

Guglielmi

et al. 2021

Acta Ophthalmologica

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Purpose To compare the performance of focal electroretinogram (FERG) and fast mesopic microperimetry in evaluating macular function of intermediate age‐related macular degeneration (iAMD) subjects with preserved visual acuity. Methods Cross‐sectional, observational study. Participants with drusen >125 µm and VA ≥80 ETDRS letters and age‐ and sex‐comparable healthy subjects were consecutively enrolled in the study. Three photopic FERG recordings of the central 9° of the macula with luminance modulated stimuli flickering at 42.5 Hz and a fast mesopic microperimetry with a custom pattern of 3 central (CS) and 3 paracentral (pCS) stimuli at 1.2° and 6° from fixation were acquired. Results Overall, 112 eyes of 77 participants (age 73.0 ± 7.1 years, 47 iAMD eyes) were analysed. Mean FERG amplitude, CS and pCS (all p < 0.05) were lower in the iAMD group. A significant association was observed between FERG amplitude and iAMD (OR 9.58, p < 0.001) in multiple logistic regression analysis. Z‐scores of FERG were lower than microperimetry in iAMD (p = 0.002) but not for healthy participants. AUC of the ROC curve was greater for FERG than microperimetry (0.895 versus 0.644 and 0.675, both p < 0.05). Conclusion Focal ERG objectively measures a cumulative response originating from the photoreceptor‐RPE complex of the central 9° of the macula and demonstrated high accuracy in identifying decreased central macular function in iAMD patients with preserved visual acuity, performing better than fast mesopic microperimetry. Focal ERG should be considered a reliable technique for measuring retinal sensitivity of iAMD patients.

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“…The questionnaire showed good discrimination, allowing stratification of subjects according to the risk of AMD (low, moderate, high). The translational relevance of the STARS ® score in predicting macular function in early and intermediate AMD has been recently pointed out: STARS ® is able to predict central retinal function with a high degree of accuracy, as assessed by full-field electroretinogram, which suggests that both parameters can be combined to assess the clinical risk for loss of visual function even in the early disease stages [37].…”

Section: Introductionmentioning

confidence: 99%

Exploring Consensus on Preventive Measures and Identification of Patients at Risk of Age-Related Macular Degeneration Using the Delphi Process

García‐Layana

Garhöfer

Aslam

et al. 2021

JCM

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Background: Early identification of AMD can lead to prompt and more effective treatment, better outcomes, and better final visual acuity; several risk scores have been devised to determine the individual level of risk for developing AMD. Herein, the Delphi method was used to provide recommendations for daily practice regarding preventive measures and follow-up required for subjects at low, moderate, and high risk of AMD evaluated with the Simplified Test AMD Risk-assessment Scale (STARS®) questionnaire. Methods: A steering committee of three experts drafted and refined 25 statements on the approach to be recommended in different clinical situations [general recommendations (n = 2), use of evaluation tools (n = 4), general lifestyle advice (n = 3), and AREDS-based nutritional supplementation (n = 5)] with the help of a group of international experts, all co-authors of this paper. Thirty retinal specialists from Europe and the US were chosen based on relevant publications, clinical expertise, and experience in AMD, who then provided their level of agreement with the statements. Statements for which consensus was not reached were modified and voted upon again. Results: In the first round of voting, consensus was reached for 24 statements. After modification, consensus was then reached for the remaining statement. Conclusion: An interprofessional guideline to support preventive measures in patients at risk of AMD based on STARS® scoring has been developed to aid clinicians in daily practice, which will help to optimize preventive care of patients at risk of AMD.

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Macular Function in Early and Intermediate Age-related Macular Degeneration: Correlation with the Simplified Thea Risk Assessment Scale (STARS)

Abstract: Macular function in early and intermediate age-related macular degeneration: Correlation with the simplified thea risk assessment scale (STARS). Trans

Cited by 3 publications

References 22 publications

Subretinal Pigment Epithelium Illumination Combined With Focal Electroretinogram and Visual Acuity for Early Diagnosis and Prognosis of Non-Exudative Age-Related Macular Degeneration: New Insights for Personalized Medicine

Subretinal Pigment Epithelium Illumination Combined With Focal Electroretinogram and Visual Acuity for Early Diagnosis and Prognosis of Non-Exudative Age-Related Macular Degeneration: New Insights for Personalized Medicine

Focal electroretinogram and microperimetry testing of photoreceptor‐retinal pigment epithelium function in intermediate age‐related macular degeneration

Exploring Consensus on Preventive Measures and Identification of Patients at Risk of Age-Related Macular Degeneration Using the Delphi Process

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