TY - JOUR
T1 - Peripheral Changes Associated With Delayed Dark Adaptation in Age-related Macular Degeneration
AU - Laíns, Inês
AU - Park, Dong Ho
AU - Mukai, Ryo
AU - Silverman, Rebecca
AU - Oellers, Patrick
AU - Mach, Steven
AU - Kim, Ivana K.
AU - Vavvas, Demetrios G.
AU - Miller, Joan W.
AU - Miller, John B.
AU - Husain, Deeba
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Purpose: To study the association between peripheral changes in age-related macular degeneration (AMD) and dark adaptation (DA). Design: Prospective, cross-sectional study. Methods: We recruited patients with AMD and a control group (>50 years) without any vitreoretinal disease. Ultra-widefield (UWF) pseudocolor and fundus autofluorescence (FAF) were obtained, and were assessed by 2 graders for the presence of several peripheral changes in perimacular, midperipheral, and far-peripheral zones. All participants were also imaged with 7-field color fundus photographs used for AMD staging (Age-Related Eye Disease Study classification system). Both eyes of study participants were tested with a dark adaptation (DA) extended protocol (20 minutes). Multilevel mixed-effect models (accounting for correlated outcomes between 2 eyes) were used for analyses. Results: We included 128 eyes (n = 72 patients), 75% with AMD and the remainder controls. The presence of reticular pigmentary changes in the midperipheral (ß = 4.3, P =.012) and far-peripheral zones (ß = 8.4, P <.001) was associated with delayed rod-intercept times (RITs), even after adjusting for confounding factors. The presence, number, and extent of peripheral classic drusen did not show a similar association (P ≥.148). The presence of a mottled decreased FAF pattern in the midperipheral zone was also associated with prolonged RITs (β = 4.4, P =.031). Conclusion: Our results suggest an association between DA and the presence of peripheral reticular pigmentary changes, as well as the presence of a peripheral mottled decreased FAF pattern. This provides new insights on the clinical significance of peripheral changes in AMD, and their contribution to impairments on DA.
AB - Purpose: To study the association between peripheral changes in age-related macular degeneration (AMD) and dark adaptation (DA). Design: Prospective, cross-sectional study. Methods: We recruited patients with AMD and a control group (>50 years) without any vitreoretinal disease. Ultra-widefield (UWF) pseudocolor and fundus autofluorescence (FAF) were obtained, and were assessed by 2 graders for the presence of several peripheral changes in perimacular, midperipheral, and far-peripheral zones. All participants were also imaged with 7-field color fundus photographs used for AMD staging (Age-Related Eye Disease Study classification system). Both eyes of study participants were tested with a dark adaptation (DA) extended protocol (20 minutes). Multilevel mixed-effect models (accounting for correlated outcomes between 2 eyes) were used for analyses. Results: We included 128 eyes (n = 72 patients), 75% with AMD and the remainder controls. The presence of reticular pigmentary changes in the midperipheral (ß = 4.3, P =.012) and far-peripheral zones (ß = 8.4, P <.001) was associated with delayed rod-intercept times (RITs), even after adjusting for confounding factors. The presence, number, and extent of peripheral classic drusen did not show a similar association (P ≥.148). The presence of a mottled decreased FAF pattern in the midperipheral zone was also associated with prolonged RITs (β = 4.4, P =.031). Conclusion: Our results suggest an association between DA and the presence of peripheral reticular pigmentary changes, as well as the presence of a peripheral mottled decreased FAF pattern. This provides new insights on the clinical significance of peripheral changes in AMD, and their contribution to impairments on DA.
UR - http://www.scopus.com/inward/record.url?scp=85045438299&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2018.03.035
DO - 10.1016/j.ajo.2018.03.035
M3 - Article
C2 - 29621510
AN - SCOPUS:85045438299
SN - 0002-9394
VL - 190
SP - 113
EP - 124
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -