Cone photoreceptor macular function and recovery after photostress in early non-exudative age-related macular degeneration

• Published in: Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2018-01, Vol.12, p.1325-1335
• Main Authors: Rodriguez, John D, Lane, Keith, Hollander, David A, Shapiro, Aron, Saigal, Sunita, Hertsenberg, Andrew J, Wallstrom, Garrick, Narayanan, Divya, Angjeli, Endri, Abelson, Mark B
• Format: Article
• Language: English
• Subjects: Age; AMD; Atrophy; Cone recovery; Diabetes; Diabetic retinopathy; Disease; Macular degeneration; Ophthalmology; Original Research; Photobleach; Photoreceptor; Photoreceptors; Physiological aspects; Retina; Studies
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S165658

To identify parameters from cone function and recovery after photostress that detect functional deficits in early non-exudative age-related macular degeneration (AMD) and to determine the repeatability of these parameters. Cone-mediated visual function recovery after photostress was examined in three groups of subjects: young normal subjects (ages 20-29; N=8), older normal subjects (ages 50-90; N=9), and early non-exudative AMD subjects (ages 50-90; N=12). Eight AMD and four normal subjects were retested 1 year after the initial evaluation. Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) and parameters of cone function (baseline cone sensitivity and cone recovery half-life following photobleach) were measured and compared between AMD and normal subjects. Short-term repeatability was assessed for each subject's initial evaluation. Long-term repeatability was assessed by comparing outcomes from the initial evaluation and 1-year follow-up. The mean baseline cone threshold was significantly worse in subjects with early AMD compared to older normal subjects (-1.80±0.04 vs -1.57±0.06 log cd/m =0.0027). Moreover, the baseline cone threshold parameter exhibited good short-term (intraclass correlation coefficient [ICC]=0.88) and long-term (ICC=0.85) repeatability in all subjects. The cone intercept parameter and ETDRS VA were not significantly different between AMD and older normal subject groups. Cone recovery half-life was significantly different between older normal and AMD subject groups ( =0.041). Neither ETDRS VA nor cone function parameters were significantly different for any group at the 1-year follow-up. The baseline cone threshold shows potential as a novel parameter to assess visual dysfunction in early AMD. This outcome consistently detected deficits in AMD subjects, and differentiated them from age-matched controls with high test-retest repeatability.