The Relationship Between Central Drusen Volume and Low-Luminance Deficit in Age-Related Macular Degeneration

Abstract

Citation: Ou WC, Denlar RA, Csaky KG. The relationship between central drusen volume and low-luminance deficit in age-related macular degeneration. Trans Vis Sci Tech. 2020;9(4):10, https://doi.org/10. 1167/tvst.9.4.10 Purpose: To determine the relationship between central drusen volume and lowluminance deficit (LLD) in visual acuity (VA) in patients with intermediate age-related macular degeneration (AMD). Methods:In this cross-sectional study, 42 patients with intermediate AMD underwent testing for VA and low-luminance VA (LLVA), as well as spectral-domain optical coherence tomography. LLD was calculated as the difference between VA and LLVA. Central drusen volume was measured in the central 3 mm of the macula, defined as the volume between the inner border of the retinal pigment epithelium and Bruch's membrane.Results: Mean ± standard deviation (SD) LLD was 0.32 ± 0.12 logMAR and mean ± SD drusen volume was 0.18 ± 0.09 mm 3 . No linear relationship was identified between central 3 mm drusen volume and LLD (P = 0.215). R 2 for the bivariate linear model was 0.038 (95% confidence interval 0-0.222). Limitation of the analysis to drusen volumes measured in the central 1 mm of the macula did not impact results (R 2 = 0.075), nor did incorporation of lens status into the model (R 2 = 0.067) or censoring of patients with nonfoveal subretinal drusenoid deposits (R 2 = 0.071). Conclusions:The amount of drusen within the central 3 mm of the macula does not appear to be related to LLD in intermediate AMD. These measures may be manifestations of different underlying pathophysiological mechanisms.Translational Relevance: Understanding relationships between markers for AMD progression may help guide development of improved clinical grading scales for AMD.

Correlation between hyperreflective foci and visual function testing in eyes with intermediate age-related macular degeneration

“…Coincidentally, our HRF group also had a higher mean central drusen volume. In our secondary analysis adjusting for the presence and absence of HRF, cube-root transformed central drusen volume was found to be associated with LLD measurement, which was in contrast to our prior study showing no such correlation in eyes with iAMD [9]. In our previous study, the presence of HRF was not evaluated, so it was possible that the lack of adjustment for HRF accounted for the negative finding.…”

“…Neely et al [8] found that in eyes with early AMD, dark adaptation was significantly delayed in eyes with SDD as compared to eyes without SDD, but the difference was no longer statistically significant after adjusting for age. In addition, Ou et al [9] did not find a correlation between central drusen volume and low luminance deficit in eyes with iAMD. However, Ou et al [10] did detect statistically significant differences between controls and intermediate/advanced (non-neovascular) AMD eyes in both normal and low luminance quantitative contrast sensitivity function (qCSF), as measured in area under log CSF (AULCSF).…”

“…Inclusion criteria included: patients aged 55 years or older, iAMD as determined by retinal specialist (K.G.C) based on clinical examination and multimodal imaging, [16] and VA of 55 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or more (Snellen 20/80 or better). Exclusion criteria included: presence of other significant retinal pathology, inability to complete study examinations, choroidal neovascularization, geographic atrophy on clinical examination, presence of incomplete (iRORA) or complete retinal pigment epithelium and outer retinal atrophy (cRORA) [17] on OCT, or presence of SDDs of > 9 disc areas (DA) in total or > 0.25 DA within 1 mm of the fovea [9]. iAMD patients with and without HRF on OCT imaging, as determined by two retinal specialists (K.G.C.…”

Early Stages of Age-Related Macular Degeneration: Racial/Ethnic Differences and Proposal of a New Classification Incorporating Emerging Concept of Choroidal Pathology

“…However, different from eyes with SDDs, it remains unknown whether the function of the retina changes with an increased soft drusen load; a study demonstrated that, functionally, the amount of drusen within the central 3 mm of the macula does not appear to be related to low-luminance deficit in intermediate AMD [ 35 ].…”