Photoreceptor Damage and Reduction of Retinal Sensitivity Surrounding Geographic Atrophy in Age-Related Macular Degeneration

Takahashi, Ayako; Ooto, Sotaro; Yamashiro, Kenji; Oishi, Akio; Tamura, Hiroshi; Nakanishi, Hideo; Ueda-Arakawa, Naoko; Tsujikawa, Akitaka; Yoshimura, Nagahisa

doi:10.1016/j.ajo.2016.06.006

Cited by 50 publications

(42 citation statements)

References 34 publications

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“…19 It has also been identified in clinically preserved macular areas in the topography of quiescent NV 20 or surrounding overt GA lesions. 21,22 Prior evidence of early photoreceptor dysfunction in the course and progression of AMD is in alignment with our anatomic findings.…”

Section: Discussionsupporting

confidence: 87%

Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

Ferrara

Silver

Louzada

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeAge-related macular degeneration (AMD) is a progressive disease with multifactorial etiology. There is a need to identify clinical features that are harbingers of advanced disease. We evaluated morphologic features of the retina and choroid on optical coherence tomography (OCT) to determine if they predict progression to advanced disease.MethodsProgressors transitioned from early or intermediate AMD to advanced disease (n = 40 eyes), and were matched on baseline AMD grade and follow-up interval to nonprogressors who did not develop advanced AMD (n = 40 eyes). Features of the neurosensory retina, photoreceptors, retinal pigment epithelium (RPE), and choroid were evaluated. Logistic regression was used to evaluate univariate associations between features and progression to overall advanced AMD, geographic atrophy (GA), and neovascular disease (NV). Multivariate associations based on stepwise regression models were also assessed.ResultsEllipsoid zone disruption was associated with progression to overall advanced AMD and NV (odds ratios [ORs]: 17.9 and 30.6; P < 0.001), with a similar trend observed for GA. Drusenoid RPE detachment, RPE thickening, and retinal pigmentary hyperreflective material were significantly associated with higher risk of progression to advanced AMD (ORs: 5.0–8.5) and NV (ORs: 10.8–17.2). Pigmentary hyperreflective material was associated with progression to GA (OR: 7.5, P = 0.009). Total retinal thickness, pigmentary hyperreflective material, nascent GA features, and choroidal vessel abnormalities were independently associated with progression to advanced AMD in a multivariate stepwise model.ConclusionsAbnormalities in the photoreceptors, retinal thickness, RPE, and choroid were associated with higher risk of developing advanced AMD. These findings provide insights into disease progression, and may be helpful to identify earlier endpoints for clinical studies.

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Section: Discussionsupporting

confidence: 87%

Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

Ferrara

Silver

Louzada

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…16 Several studies of eyes with GA have found reduced retinal sensitivity at the border of GA lesions compared with adjacent points in the retina. 17,37,42,58 In particular, retinal sensitivity was decreased in regions with photoreceptor damage (3.28 AE 2.70 dB) compared with undamaged regions (10.52 AE 4.12 dB). 58 In eyes with foveal-sparing GA, the perilesional sensitivity of the foveal region was found to be higher than that of the perifoveal area of atrophy.…”

Section: Perilesional Sensitivitymentioning

confidence: 96%

“…17,37,42,58 In particular, retinal sensitivity was decreased in regions with photoreceptor damage (3.28 AE 2.70 dB) compared with undamaged regions (10.52 AE 4.12 dB). 58 In eyes with foveal-sparing GA, the perilesional sensitivity of the foveal region was found to be higher than that of the perifoveal area of atrophy. 13 To properly analyze junctional zone defects, the location and size of the GA lesion must be taken into account.…”

Section: Perilesional Sensitivitymentioning

confidence: 96%

“…Eyes with GA and intermediate AMD possess a macula-wide functional deficit, indicated by decreased mean retinal sensitivity. 17,58,61,62,65,66 This functional decline may precede the development of GA. 25,65 Several studies have used mesopic microperimetry to evaluate mean retinal sensitivity in the presence of reticular pseudodrusen (RPD). In eyes with foveal-sparing GA, the presence of pseudodrusen was highly predictive of mean retinal sensitivity (P ¼ 0.004) and resulted in decreased retinal sensitivity across the entire macula.…”

Section: Mean Retinal Sensitivity (Total Retinal Area)mentioning

confidence: 99%

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Microperimetry for geographic atrophy secondary to age-related macular degeneration

Csaky

Patel

Sepah

et al. 2019

Survey of Ophthalmology

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Geographic atrophy (GA) is a progressive, advanced form of age-related macular degeneration leading to visual function impairment and irreversible vision loss. Standard clinical tests to evaluate visual function in patients with GA provide poor anatomic-functional correlation, whereas fundus imaging does not assess the visual function deficit. Microperimetry is a psychophysical visual function test that spatially maps retinal sensitivity and allows for identification of correlation of anatomic features with visual function. In this review, we present an overview of mesopic microperimetry for GA, including commercially available microperimetry devices, strategies to capture a mesopic microperimetry test, and strategies to assess and interpret microperimetry data in patients with GA. We demonstrate the importance of microperimetry data for assessing GA progression and for evaluating visual function loss through anatomic-functional

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“…1, right). It has been observed that these abnormalities are highly correlated with focal vision impairment [6] and visual acuity loss when located at the central area of the retina [7]. Hence, the automated characterization of the morphology of the photoreceptor layer is relevant for efficient quantification of functional loss.…”

Section: Introductionmentioning

confidence: 99%

An Amplified-Target Loss Approach for Photoreceptor Layer Segmentation in Pathological OCT Scans

Orlando

Breger

Bogunović

et al. 2019

Lecture Notes in Computer Science

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Segmenting anatomical structures such as the photoreceptor layer in retinal optical coherence tomography (OCT) scans is challenging in pathological scenarios. Supervised deep learning models trained with standard loss functions are usually able to characterize only the most common disease appearance from a training set, resulting in suboptimal performance and poor generalization when dealing with unseen lesions. In this paper we propose to overcome this limitation by means of an augmented target loss function framework. We introduce a novel amplified-target loss that explicitly penalizes errors within the central area of the input images, based on the observation that most of the challenging disease appearance is usually located in this area. We experimentally validated our approach using a data set with OCT scans of patients with macular diseases. We observe increased performance compared to the models that use only the standard losses. Our proposed loss function strongly supports the segmentation model to better distinguish photoreceptors in highly pathological scenarios. equal contribution arXiv:1908.00764v2 [eess.IV]

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Photoreceptor Damage and Reduction of Retinal Sensitivity Surrounding Geographic Atrophy in Age-Related Macular Degeneration

Abstract: Widespread photoreceptor damage surrounding sites of RPE loss occurred in eyes with GA, and it correlated with visual function. Evaluation of photoreceptor damage surrounding sites of RPE loss using OCT is important in patients with GA associated with AMD.

Cited by 50 publications

References 34 publications

Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration

Microperimetry for geographic atrophy secondary to age-related macular degeneration

An Amplified-Target Loss Approach for Photoreceptor Layer Segmentation in Pathological OCT Scans

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