Retinal Spectral Domain Optical Coherence Tomography in Early Atrophic Age-Related Macular Degeneration AMD and a New Metric for Objective Evaluation of the Efficacy of Ocular NutritionReport as inadecuate




Retinal Spectral Domain Optical Coherence Tomography in Early Atrophic Age-Related Macular Degeneration AMD and a New Metric for Objective Evaluation of the Efficacy of Ocular Nutrition - Download this document for free, or read online. Document in PDF available to download.

1

Eye Clinic, James A Lovell Federal Health Care Center, North Chicago, IL 60064, USA

2

Family & Preventive Medicine, RFUMS Chicago Medical School, North Chicago, IL 60064, USA

3

Internal Medicine, Podiatry Services, University of Michigan, Ann Arbor, MI 48105, USA

4

Optovue Inc., Fremont, CA 94538, USA





*

Author to whom correspondence should be addressed.



Abstract Purpose: A challenge in ocular preventive medicine is identification of patients with early pathological retinal damage that might benefit from nutritional intervention. The purpose of this study is to evaluate retinal thinning RT in early atrophic age-related macular degeneration AMD against visual function data from the Zeaxanthin and Visual Function ZVF randomized double masked placebo controlled clinical trial FDA IND #78973. Methods: Retrospective, observational case series of medical center veterans with minimal visible AMD retinopathy AREDS Report #18 simplified grading 1.4-4.0 bilateral retinopathy. Foveal and extra-foveal four quadrant SDOCT RT measurements were evaluated in n = 54 clinical and ZVF AMD patients. RT by age was determined and compared to the OptoVue SD OCT normative database. RT by quadrant in a subset of n = 29 ZVF patients was correlated with contrast sensitivity and parafoveal blue cone increment thresholds. Results: Foveal RT in AMD patients and non-AMD patients was preserved with age. Extrafoveal regions, however, showed significant slope differences between AMD patients and non-AMD patients, with the superior and nasal quadrants most vulnerable to retinal thinning sup quad: −5.5 μm-decade thinning vs. Non-AMD: −1.1 μm-decade, P < 0.02; nasal quad: −5.0 μm-decade thinning vs. Non-AMD: −1.0 μm-decade, P < 0.04. Two measures of extrafoveal visual deterioration were correlated: A significant inverse correlation between % RT and contrast sensitivity r = −0.33, P = 0.01, 2 Tailed Paired T and an elevated extrafoveal increment blue cone threshold r = +0.34, P = 0.01, 2 Tailed T. Additional SD OCT RT data for the non-AMD oldest age group ages 82–91 is needed to fully substantiate the model. Conclusion: A simple new SD OCT clinical metric called -% extra-foveal RT- correlates well with functional visual loss in early AMD patients having minimal visible retinopathy. This metric can be used to follow the effect of repleting ocular nutrients, such as zinc, antioxidants, carotenoids, n-3 essential fats, resveratrol and vitamin D. View Full-Text

Keywords: atrophic age-related macular degeneration AMD; spectral domain OCT SD OCT; contrast sensitivity function CSF; extrafoveal blue-cone increment thresholds atrophic age-related macular degeneration AMD; spectral domain OCT SD OCT; contrast sensitivity function CSF; extrafoveal blue-cone increment thresholds





Author: Stuart Richer 1,2,* , Jane Cho 1,2, William Stiles 1, Marc Levin 1, James S. Wrobel 3, Michael Sinai 4 and Carla Thomas 1

Source: http://mdpi.com/



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