Static and flicker perimetry in age-related macular degeneration

• Published in: Investigative ophthalmology & visual science 2013-05, Vol.54 (5), p.3560-3568
• Main Authors: Luu, Chi D, Dimitrov, Peter N, Wu, Zhichao, Ayton, Lauren N, Makeyeva, Galina, Aung, Khin-Zaw, Varsamidis, Mary, Robman, Luba, Vingrys, Algis J, Guymer, Robyn H
• Format: Article
• Language: English
• Subjects: Aged; Cross-Sectional Studies; False Negative Reactions; False Positive Reactions; Female; Humans; Longitudinal Studies; Macular Degeneration - diagnosis; Macular Degeneration - physiopathology; Male; Middle Aged; Optic Disk Drusen - diagnosis; Optic Disk Drusen - physiopathology; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Visual Acuity; Visual Field Tests - methods; Visual Field Tests - standards; Visual Fields
• ISSN: 1552-5783; 1552-5783
• DOI: 10.1167/iovs.12-10465

The relationship between clinical severity of age-related macular degeneration (AMD) and macular function has not been well established. In this study, we investigated the correlation between clinical severity and functional deficits as detected by static and flicker perimetry. This cross-sectional study consisted of 279 AMD subjects and 24 control participants. AMD subjects were allocated into 1 of 10 AMD severity groups depending on the status of the designated study eye and the fellow eye, as assessed by color fundus photographs. Visual acuity, and static and flicker perimetry were tested on one eye during the same session. The geometric means, SDs, and percentage of abnormal eyes of static and flicker sensitivity of each AMD severity group were determined and compared. The pattern of change in sensitivity and percentage of abnormal eyes for static perimetry across all AMD severity groups were similar to flicker perimetry. Eyes with drusen > 125 μm (P[static] = 0.018, P[flicker] = 0.024), drusenoid epithelial detachment (P[static and flicker] < 0.001) and noncentral geographic atrophy (GA; P[static and flicker] < 0.001) had significant reductions in static and flicker sensitivities compared to normal eyes. Static (β-coefficient -1.59, 95% confidence interval [CI] -4.78-1.60) and flicker (β-coefficient -1.29, 95% CI -4.66-2.08) sensitivities declined at a similar rate in eyes that showed clinical signs of progression. Static and flicker perimetry were affected similarly across the spectrum of AMD severity, and methods appeared to be valid techniques for assessing retinal sensitivity in AMD once drusen > 125 μm are present, but before the development of late AMD.