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. 2015 Jun;133(6):690-7.
doi: 10.1001/jamaophthalmol.2015.0477.

Scotopic and Photopic Microperimetry in Patients With Reticular Drusen and Age-Related Macular Degeneration

Julia S Steinberg  1 , Fred W Fitzke  2 , Rolf Fimmers  3 , Monika Fleckenstein  1 , Frank G Holz  1 , Steffen Schmitz-Valckenberg  1
Affiliations

Scotopic and Photopic Microperimetry in Patients With Reticular Drusen and Age-Related Macular Degeneration

Julia S Steinberg et al. JAMA Ophthalmol. 2015 Jun.

Abstract

Importance: Clinical observations suggest that patients with age-related macular degeneration (AMD) have vision problems, particularly in dim light conditions. Previous studies on structural-functional analysis in patients with AMD with reticular drusen (RDR) have focused on photopic sensitivity testing but have not specifically assessed scotopic function.

Objective: To evaluate retinal function by scotopic and photopic microperimetry in patients with AMD and a well-demarcated area of RDR.

Design, setting, and participants: Prospective case series in a referral center of 22 eyes from 18 patients (mean age, 74.7 years; range, 62-87 years). The study was conducted from June 1, 2014, to October 31, 2014.

Interventions: With the use of combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging, retinal areas with RDR (category 1) and no visible pathologic alterations (category 2) were identified in each eye. Scotopic and photopic microperimetry (MP-1S; Nidek Technologies) was performed using a grid with 56 stimulus points.

Main outcomes and measures: Comparison of mean threshold sensitivities for each category for scotopic and photopic microperimetry.

Results: In all eyes, areas of category 1 showed a relative and sharply demarcated reduction of scotopic threshold values compared with areas of category 2, but only less-pronounced differences were seen for photopic testing. Statistical analysis in the 18 eyes in which the 1.0-log unit neutral density filter was applied revealed a difference of scotopic threshold values in areas of category 1 (mean, 13.5 dB [95% CI, 12.1-15.0]) vs category 2 (mean, 18.3 dB; [95% CI, 17.4-19.3] (P ≤ .001). For photopic testing, the mean threshold values were 16.8 dB (95% CI, 15.5-18.2) in category 1 and 18.4 dB (95% CI, 17.1-19.6) in category 2 (P = .03).

Conclusions and relevance: The results of this study suggest that rod function is more severely affected than cone function in retinal areas with RDR. This differential structural-functional correlation underscores the functional relevance of RDR in patients with AMD.

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