First Author: M.Pfau GERMANY
Co Author(s): M. Lindner M. Gliem R. Finger M. Fleckenstein F. Holz S. Schmitz-Valckenberg
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To examine the feasibility and utility of dark-adapted two-colour fundus-controlled perimetry (FCP) with the S-MAIA (Scotopic-Macular-Integrity-Assessment, centreVue, Padova, Italy) device in patients with cuticular, reticular and soft drusen and to compare FCP data to microstructural Spectral-domain optical coherence tomography (SD-OCT) data.
Department of Ophthalmology, University of Bonn, Bonn, Germany (tertiary referral centre)
Forty-four eyes (24 eyes of 24 patients with drusen, age 69.4±12.6years; 20 normal eyes of 16 subjects, 61.7±12.4years) underwent duplicate mesopic, dark-adapted cyan and dark-adapted red FCP within 14° of the central retina (total of 12,936 threshold tests). FCP data were registered to SD-OCT data to obtain outer nuclear layer, inner and outer photoreceptor segment and retinal-pigment-epithelium-drusen-complex (RPEDC) thickness data spatially corresponding to the stimulus-location and -area (0.43°). Structure-function-correlations were assessed using mixed-effects models.
Mean deviation values for eyes with cuticular, soft and reticular drusen were similar for mesopic (-2.1dB; -3.4dB; -3.6dB) and dark-adapted red (-1.4dB; -2.6dB; -3.3dB) FCP. For dark-adapted cyan FCP (0.1dB; -1.9dB; -5.0dB) and for the cyan-red sensitivity difference (+1.0dB; +0.5dB; -2.4dB), the mean deviation values differed significantly in dependence of the predominant drusen type (one-way ANOVA; p<0.05). RPEDC thickness was associated with reduction of mesopic sensitivity (-0.34dB/10µm RPEDC-thickening; p<0.001), dark-adapted cyan sensitivity (-0.11dB/10µm RPEDC-thickening; p=0.003) and dark-adapted red sensitivity (-0.26 dB/10µm RPEDC-thickening; p<0.001).
In contrast to mesopic FCP, dark-adapted two-colour FCP allowed for meaningful differential testing of rod- and cone-function in patients with drusen indicating predominant cone-dysfunction in eyes with cuticular drusen and indicating predominant rod-dysfunction in eyes with reticular drusen. RPEDC thickness was the strongest predictor of the evaluated SD-OCT biomarkers for point-wise sensitivity.