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.
Highlights
Age-related macular degeneration (AMD) is the leading cause of vision loss in both developed and developing countries [1,2,3]
spectral/Fourier domain optical coherence tomography (SD OCT) data set, de-identified clinical data on a random subset of age-related macular degeneration (AMD) clinic patients was merged with the Zeaxanthin and Visual Function (ZVF) 12 month visual function data subset
AMD patients from the ZVF study (n = 29 AMD retinas) and the larger merged clinical/research AMD data set (n = 54 AMD retinas), ages 50+ reveal: (1) slightly thinner foveal thickness compared to these “Normals” and (2) a thickness that does not change with age
Summary
Age-related macular degeneration (AMD) is the leading cause of vision loss in both developed and developing countries [1,2,3]. The initial clinical stereoscopic ophthalmoscopic manifestations of the dry form of the disease are drusen formation and RPE hypo/hyper pigmentation. These signs have been used in large scale “ocular nutrient” studies such as AREDS I and II to monitor disease and stratify risk of progression. Lipofuscin is the most consistent and phylogenically constant marker of cellular aging that can be useful for managing
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
