Anatomical-functional concordance of microperimetry and the simplified age-related macular degeneration study classification: A pilot study

Abstract

Purpose: The principal aim of this pilot study was to investigate the concordance between the different stages of Age-Related Macular Degeneration (AMD), as determined by the simplified classification of the Age Related Eye Disease Study Group (AREDS), and new evaluation criteria using a microperimetry system. Methods: A complete eye examination and a microperimetry MAIATM (Macular Integrity Assessment, CenterVue, Padova, Italy) examination was performed on 59 eyes with early, intermediate or advanced AMD. We analysed 19 evaluation criteria for every clinical group category. Results: There were 20 female and 12 male participants included with a median age of 74 years (min: 54, max: 87). Thirteen eyes (22%) were classified as category 1, 11 eyes (18.6%) as category 2, 17 eyes (28.8%) as category 3 and 18 eyes (30.6%) as category 4 AMD. All evaluated microperimetry criteria related to retinal sensitivity were found to have a statistically significant difference among the stages ( p < 0.05). Fixation stability was unstable in 55.6% of the eyes classified as stage 4 ( p = 0.001). The analysis of the distance between the two PRLs – PRL_initial and PRL_final was larger for the stage 4 ( p = 0.0258). The mean sensitivity in stages 2 and 3 correlated with the presence or not of reticular pseudodrusen ( p = 0.0137). Conclusions: The mean sensitivity and the categorized sensitivity (set to 25, 15 and 5 dB), the five higher and lower stimuli sensitivity appeared to be the most sensitive criteria to differentiate the four AMD categories. Microperimetry provides a new reproducible method of anatomical-functional macular analysis.