Comparing 2-dimensional macular pigment optical density with objective and subjective perimetry and visual acuity in age-related macular degeneration

Bhim B Rai; Faran Sabeti; Joshua P van Kleef; Corinne F Carle; Emilie M F Rohan; Rohan W Essex; Richard C Barry; Ted Maddess

doi:10.1007/s00417-024-06437-6

Comparing 2-dimensional macular pigment optical density with objective and subjective perimetry and visual acuity in age-related macular degeneration

Graefes Arch Clin Exp Ophthalmol. 2024 Mar 14. doi: 10.1007/s00417-024-06437-6. Online ahead of print.

Authors

Bhim B Rai¹, Faran Sabeti^{2

3}, Joshua P van Kleef², Corinne F Carle², Emilie M F Rohan², Rohan W Essex⁴, Richard C Barry⁵, Ted Maddess²

Affiliations

¹ John Curtin School of Medical Research, Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia. bhim.rai@anu.edu.au.
² John Curtin School of Medical Research, Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia.
³ Faculty of Health, School of Optometry, University of Canberra, Canberra, ACT, Australia.
⁴ Department of Ophthalmology, Canberra Hospital, Canberra, ACT, Australia.
⁵ Blink Eye Clinic, Canberra, ACT, Australia.

PMID: 38483610
DOI: 10.1007/s00417-024-06437-6

Abstract

Purpose: To compare diagnostic power for different severities of age-related macular degeneration (AMD) of two-dimensional macular pigment optical densities (2D-MPOD) and spatially matched objective perimetry, with standard perimetry and best-corrected visual acuity (BCVA).

Methods: The ObjectiveField Analyser (OFA) provided objective perimetry, and a Heidelberg Spectralis optical coherence tomography (OCT) measured 2D-MPOD in AMD patients, both completed twice over 0.99 ± 0.16 years. From each 2D-MPOD image, we extracted 20 regions/macula, matched to the 20 OFA stimuli/macula. For each region, we calculated 7 measures from the 2D-MPOD pixel values and correlated those with OFA sensitivities and delays. We quantified 2D-MPOD changes, the ability of 2D-MPOD and OFA to discriminate AMD stages, and the discriminatory power of Matrix perimetry and BCVA using percentage area under receiver operator characteristic plots (%AUROC).

Results: In 58 eyes of 29 subjects (71.6 ± 6.3 years, 22 females), we found significant correlations between 2D-MPOD and OFA sensitivities for Age-Related Eye Disease Studies (AREDS)-3 and AREDS-4 severities. Delays showed significant correlations with AREDS-2. For AREDS-4, correlations extended across all eccentricities. Regression associated with the Bland-Altman plots showed significant changes in 2D-MPOD over the study period, especially variability measures. MPOD per-region medians discriminated AREDS-1 from AREDS-3 eyes at a %AUROC of 80.0 ± 6.3%, outperforming OFA, Matrix perimetry, and BCVA.

Conclusions: MPOD changes correlated with central functional changes and significant correlations extended peripherally in later-stage AMD. Good diagnostic power for earlier-stage AMD and significant change over the study suggest that 2D-MPOD and OFA may provide effective biomarkers.

Keywords: 2D-MPOD; AMD; Intermediate AMD; Macular pigment density; Multifocal; Objective perimetry.

Abstract

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