Visual Sensitivity Loss in Geographic Atrophy: Structure-Function Evaluation Using Defect-Mapping Microperimetry

Zhichao Wu

doi:10.1167/iovs.65.1.36

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Visual Sensitivity Loss in Geographic Atrophy: Structure-Function Evaluation Using Defect-Mapping Microperimetry

2024-01-19

Peter van Wijngaarden

Robyn H. Guymer

DOI：10.1167/iovs.65.1.36

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Abstract

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PURPOSE. To examine the structure-function relationship in eyes with geographic atrophy (GA) using defect -mapping microperimetry, a testing strategy optimized to quantify the spatial extent of deep visual sensitivity losses. METHODS. Fifty participants with GA underwent defect -mapping microperimetry testing of the central 8(degrees) -radius region (208 locations tested once with a 10 -decibel stimuli) and fundus autofluorescence imaging in one eye. The GA extent in the corresponding central 8(degrees) -radius was derived by manual annotations and image co -registration to examine the global structure-function relationship. The distance of each test location from the GA margin was also derived, and regions defined, to examine the local structure-function relationship. RESULTS. GA extent in the central 8 degrees explained a substantial proportion of variance in the percentage of locations missed (nonresponse) on microperimetry at the global level (R-2 = 0.90). At a local level, the probability of missing stimuli at the outer junctional zone (0-500 pm outside the GA margin) and GA margin (probability = 7% and 34%, respectively) was higher than at the outer nonlesional zone (>500 pm outside the GA margin; probability = 2%; P < 0.001 for both). The probability of missing stimuli at the inner junctional zone (0-250 pm inside the GA margin) was also lower than at the inner lesional zone (>250 pm inside the GA margin; probability = 64% and 88%; P < 0.001). CONCLUSIONS. This study confirms the expected functional relevance of the region with GA on fundus autofluorescence imaging and underscores the potential effectiveness of defect -mapping microperimetry testing for capturing visual function changes when evaluating new GA treatments.

Keywords:

geographic atrophy

microperimetry

fundus autofluorescence

structure- function

visual field tests

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