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

Abstract

Purpose

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.

Methods

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.

Results

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/m² p=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 (p=0.041). Neither ETDRS VA nor cone function parameters were significantly different for any group at the 1-year follow-up.

Conclusion

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.

Keywords:

• AMD
• photobleach
• photoreceptor
• cone recovery
• Ora LUX

Acknowledgments

This study was funded by Ora, Inc., Andover, MA, USA.

Disclosure

John D Rodriguez, Keith Lane, David A Hollander, Aron Shapiro, Sunita Saigal, Andrew J Hertsenberg, Divya Narayanan, and Endri Angjeli are employees of Ora, Inc. Mark B Abelson, MD is the founder of Ora, Inc. and at the time this study was completed, was the Chief Scientific Officer at Ora, Inc. Garrick Wallstrom, is an employee of Statistics & Data Corporation. The authors report no other conflicts of interest in this work.