Structure-Function Relationships in Geographic Atrophy Based on Mesopic Microperimetry, Fundus Autofluorescence, and Optical Coherence Tomography

Structure-Function Relationships in Geographic Atrophy

Study Overview

This study explores how retinal structure relates to visual function in geographic atrophy (GA). We focus on the connection between areas of vision loss (scotomas) and specific retinal features, particularly:

Choroidal hypertransmission: A key sign of complete retinal pigment epithelium and outer retinal atrophy.
Fundus autofluorescence (FAF): A method used to define GA.

Methods Used

We conducted a phase II trial using mesopic microperimetry and various imaging techniques over time. We analyzed:

Horizontal and vertical scans from optical coherence tomography (OCT).
Grading of FAF images for GA.

We measured how closely the areas of vision loss matched the atrophy features using a statistical method called the Dice similarity coefficient (DSC).

Key Findings

The study included 24 participants with an average follow-up of 26.8 months. Our results showed:

The average DSC for scotomas and choroidal hypertransmission was 0.70, indicating a strong match.
This match was better than the one found with FAF-defined GA, which had a DSC of 0.67.
Higher choroidal reflectivity was linked to greater chances and severity of vision loss.

Conclusions

There is a good connection between areas of vision loss and structural features of GA, especially with choroidal hypertransmission. This suggests that it could be a valuable measure in clinical trials. OCT provides more insights into visual function compared to FAF alone. However, since there are some differences in the findings, using microperimetry alongside imaging is still essential.

Practical Implications

The insights from this study enhance our understanding of how retinal structure impacts visual function, which is crucial for developing effective treatments.

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