This article was originally published in a sponsored newsletter.

Recent developments in ophthalmic disease research were presented at the 2024 ARVO (Association for Research in Vision and Ophthalmology) meeting. Today’s research may provide preventions, treatments and even cures for people affected by AMD. This month, we will concentrate on studies that involve structure and function.

Microperimetry for Early and Intermediate AMD Treatment Studies

There is currently a lack of treatments for early and intermediate AMD, but Giulia Corradetti, MD, and colleagues found that changes in microperimetry are highly localized and dependent on certain OCT features. For example, a thin “double layer sign” and acquired vitelliform lesions were associated with a decreased pointwise sensitivity. This finding is particularly important because structure to function studies offer an opportunity to assess subtle changes in early and intermediate AMD, before the development of geographic atrophy. Microperimetry could be leveraged to facilitate and optimize the design of early intervention clinical trials (see Figure 1).¹

AIM Dark Adaptation

The retina becomes more prone to damage as we age, and accurate methods are needed to identify clinical signs of early reduced visual function. One biomarker for outer retinal processing impairment is delayed dark adaptation after being exposed to bright light. Lead investigator Jan Skerswetat, PhD, and a team of researchers from Northeastern University and New England College of Optometry developed a method to assess retinal processing impairment called Angular Indication Measurement (AIM) Dark Adaptation.² This technology was designed to evaluate the time course of the retina’s adjustment to low light after continuous bright flashes by measuring contrast sensitivity for oriented C optotypes.²

The team tested the AIM Dark Adaptation paradigm on patients with macular disorders and healthy control participants. They found that it was able to rapidly and accurately measure how quickly contrast sensitivity recovered after exposure to bright light in both groups. Their results indicated a notable delay in dark adaptation recovery among patients with macular disorders.²

The AIM Dark Adaptation method provides a swift and individualized evaluation of the retina's capacity to recover from photostress, a functional biomarker of age-related and inherited retinal impairments. Without the need of a pretest adaption phase and special equipment, AIM Dark Adaptation holds promise as a self-administered screening tool for early detection of AMD.²

MPOD and AMD Protection Strategies

Macular pigment optical density (MPOD) refers to a measure of protective xanthophyll pigments in the macula. It is important to measure MPOD because low macular pigment is a risk factor for AMD, diabetes and diabetic eye disease.

MPOD varies between individuals and across ethnicities, and can fluctuate over time. A team of researchers from the Northeastern State University College of Optometry, Western University of Health Sciences College of Optometry, and EyePromise LLC studied MPOD among Cherokee Native Americans and Caucasians. All participants received a comprehensive eye examination that included MPOD evaluation, visual acuity, refraction and both anterior and posterior segment assessment.²

Lead investigator Pinakin G. Davey, OD, PhD, said, “MPOD is a direct and modifiable biomarker in health and disease state. The Native American MPOD levels were lower than Caucasian[s], which may explain in part the greater prevalence and risk of retinal disease. Health initiatives through dietary strategies and intake of nutritional supplements could provide the necessary protection and benefits.”²

Reference(s):

1. Coradetti G, Almidani L, Savastano MC, et al. Functional microperimetric correlates of OCT structural features in intermediate age-related macular degeneration. ARVO 2024 Abstract: 382.
2. The Association for Research in Vision and Ophthalmology-www.arvo.org. Accessed June 16, 2024. https://www.arvo.org/About/press-room/press-room/revolutionizing-retinal-research/

Joseph J. Pizzimenti, OD, FAAO is a part-time faculty member at the Rosenberg School of Optometry at the University of the Incarnate Word in San Antonio, Texas. Dr. Pizzimenti graduated from the Illinois College of Optometry and completed a residency in Rehabilitative Optometry and Ocular Disease at the University of Houston. He is a Fellow of both the American Academy of Optometry (AAO) and the Optometric Retina Society (ORS), serving as ORS President from 2012 to 2014. A long-time optometric educator, Dr. Pizzimenti is a frequent author and speaker on posterior segment disease. Financial Disclosures: Dr. Pizzimenti has received honoraria and consulting fees from EyePromise, Zeiss and Notal Vision