Ellipsoid zone reflectivity as a functional imaging biomarker for age-related macular degeneration: a MACUSTAR study report
Abstract
Abstract This study evaluated the functional relevance of relative ellipsoid zone reflectivity (rEZR) on spectral-domain optical coherence tomography as a structural biomarker for retinal integrity, focusing on its association with retinal function. Participants with age-related macular degeneration (AMD) and controls from the MACUSTAR study underwent functional testing, including mesopic fundus-controlled perimetry, best-corrected visual acuity, low-luminance visual acuity, low-luminance deficit, Moorfields Acuity Test, and Pelli-Robson contrast sensitivity, along with spectral-domain optical coherence tomography imaging. Structural and functional data were analyzed globally and spatially aligned for topographic analysis. Linear-mixed effects models, adjusted for age, sex, and eccentricity of the rEZR, assessed associations between rEZR and functional metrics. A total of 275 eyes (early AMD, n = 34; intermediate AMD, n = 152; late AMD, n = 36; controls, n = 53) from 275 participants (mean ± standard deviation age: 71.1 ± 7.2 years; 63.3% female) were included. In global analyses, rEZR was associated with the mean average threshold in mesopic fundus-controlled perimetry (coefficient estimate 0.0492, 95% confidence interval 0.0190–0.0794, p = 0.0015), low-luminance visual acuity (coefficient estimate − 0.0015, 95% confidence interval − 0.0026 to − 0.0004, p = 0.0092), Moorfields Acuity Test (coefficient estimate 0.0092, 95% confidence interval − 0.0022 to − 0.0001, p = 0.0285), and Pelli-Robson contrast sensitivity (coefficient estimate 0.0030, 95% confidence interval 0.0015–0.0045, p = 0.0001). Topographic analysis further revealed an association of rEZR with mesopic retinal sensitivity (coefficient estimate 0.0065, 95% confidence interval 0.0026–0.0104, p < 0.0001). Higher outer retinal reflectivity is linked to better retinal function in AMD and controls, supporting its potential as a biomarker for retinal integrity and function.
Article Details
Authors (91)
Yannick N. Liermann
Charlotte Behning
Ben Isselmann
Matthias Schmid
Hannah M. P. Dunbar
Ulrich F. O. Luhmann
Robert P. Finger
Steffen Schmitz-Valckenberg
Frank G. Holz
Department of Ophthalmology, University of Bonn, Bonn, Germany
Maximilian Pfau
Chi D. Luu
Marlene Saßmannshausen
Sarah Thiele
H. Agostini
L. Altay
R. Atia
F. Bandello
P. G. Basile
C. Behning
M. Belmouhand
M. Berger
A. Binns
C. J. F. Boon
M. Böttger
C. Bouchet
J. E. Brazier
T. Butt
C. Carapezzi
J. Carlton
A. Carneiro
A. Charil
R. Coimbra
M. Cozzi
D. P. Crabb
J. Cunha-Vaz
C. Dahlke
L. de Sisternes
H. Dunbar
R. P. Finger
E. Fletcher
H. Floyd
C. Francisco
M. Gutfleisch
R. Hogg
F. G. Holz
C. B. Hoyng
A. Kilani
J. Krätzschmar
L. Kühlewein
M. Larsen
S. Leal
Y. T. E. Lechanteur
M. Liew
U. F. O. Luhmann
A. Lüning
I. Marques
C. Martinho
A. Miliu
G. Montesano
Z. Mulyukov
M. Paques
B. Parodi
M. Parravano
S. Penas
T. Peters
T. Peto
M. Pfau
S. Priglinger
D. Rowen
G. S. Rubin
J. Sahel
C. Sánchez
O. Sander
M. Saßmannshausen
M. Schmid
S. Schmitz-Valckenberg
H. Schrinner-Fenske
J. Siedlecki
R. Silva
A. Skelly
E. Souied
G. Staurenghi
L. Stöhr
D. J. Taylor
J. H. Terheyden
S. Thiele
A. Tufail
M. Varano
L. Vieweg
A. Wolf
N. Zakaria