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Antony J. Wightman, Carla J. Abbott, Myra B. McGuinness, Emily Caruso, Robyn H. Guymer, Chi D. Luu; Presymptomatic Retinal Sensitivity Changes in Intermediate Age-Related Macular Degeneration Associated With New Retinal Fluid. Trans. Vis. Sci. Tech. 2019;8(6):3. https://doi.org/10.1167/tvst.8.6.3.
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To determine whether change in retinal sensitivity in areas with subretinal or intraretinal fluid secondary to age-related macular degeneration (AMD) precedes visual symptoms. If confirmed, retinal sensitivity testing could be used for home monitoring in AMD.
Individuals with intermediate AMD enrolled in a longitudinal study were seen every 6 months and underwent best-corrected visual acuity testing (BCVA), spectral domain–optical coherence tomography (SD-OCT), and microperimetry. Asymptomatic individuals who developed incidental, reading center–determined retinal fluid detected on SD-OCT were identified. The point-wise sensitivity (PWS) at the time of fluid detection was compared with 6 and 12 months prior.
Fourteen of 161 individuals developed fluid without symptoms. PWS over fluid areas at detection was reduced compared with 6 (difference −2.04 dB, P < 0.001) and 12 months (−2.27 dB, P < 0.001) prior. PWS over fluid areas was reduced compared with perifluid areas (difference −1.02 dB, P = 0.03), peripheral areas (−1.51 dB, P < 0.001), nonprogressed fellow eyes (−1.49 dB, P = 0.006), and nonprogressed age-matched intermediate AMD eyes (−2.29 dB, P = 0.001). No difference in BCVA was observed in eyes developing fluid compared to eyes that do not develop fluid (P = 0.76).
Retinal areas with fluid on SD-OCT had a corresponding reduction in retinal sensitivity at the time of fluid detection compared with 6 and 12 months prior, in asymptomatic intermediate AMD without change in BCVA.
Development of self-monitoring tools to detect changes in retinal sensitivity may be helpful for early detection of retinal fluid suggestive of progression to neovascular AMD before acuity is affected.
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