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The following is a summary of “Associations Between Contrast Sensitivity, OCT Features and Progression from Intermediate to Late Age-related Macular Degeneration,” published in the November 2024 issue of Ophthalmology by Bennett et al. 

The relationship between structure, function, and clinical outcomes in intermediate age-related macular degeneration (iAMD) is an ongoing unmet need.  

Researchers conducted a retrospective study to cross-sectionally investigate the relationship between optical coherence tomography (OCT) biomarkers and quantitative contrast sensitivity function (qCSF)-measured contrast sensitivity (CS) and longitudinally assess the association with the progression of iAMD to late-stage disease. 

They conducted a study at Massachusetts Eye and Ear (Boston, MA, USA), including eyes with baseline diagnosis of iAMD, same-day OCT and qCSF test, visual acuity (VA) ≥20/200 Snellen, and (4) 24+ months of follow-up, qCSF metrics included the area under the logCSF curve (AULCSF), contrast acuity (CA), and CS thresholds at 1-to-18 cycles per degree (cpd), 2 independent graders reviewed macular OCT scans for various biomarkers, measuring outer nuclear layer (ONL) thickness and retinal pigment epithelium (RPE) volume. Progression to wet AMD or geographic atrophy (GA) was confirmed using imaging studies. Generalized linear mixed-effects models assessed associations between qCSF and OCT biomarkers, while Cox regression models evaluated the association with progression to late AMD.  

The results showed 134 patients and 205 iAMD eyes (age: 73 [69-78] years; 63% female) were included. Higher central subfield RPE volume and more intraretinal hyperreflective foci (iHRF) were associated with reduced AULCSF, CA, and CS at 6-12 cpd (P <0.05). Inner ring ONL thinning and more iHRF were associated with reduced CS at 1 and 3 cpd (P <0.05). During follow-up, 35 eyes developed wet AMD (17%), and 53 progressed to GA (26%), SDD, inner ring ONL thinning, and reduced CS at 1.5 cpd were associated with wet AMD (P <0.05). Higher inner ring RPE volume, hDC, SDD, higher HRF count, and reduced CS at 1 cpd were associated with GA (P <0.05)  

Investigators concluded the significant structure-function relationships between OCT biomarkers and qCSF-measured CS in iAMD, emphasizing the impact of AMD alterations on contrast sensitivity function and offering valuable insights for patient stratification and prognostication. 

Source: ajo.com/article/S0002-9394(24)00523-3/abstract