summary: A new study reveals that early changes in age-related macular degeneration (AMD) can lead to measurable localized vision loss. Using advanced imaging techniques, researchers found that iRORA lesions, an early sign of retinal damage, significantly reduce vision.
This discovery could lead to improved surveillance and treatment of AMD and potentially prevent severe vision loss. The discovery offers hope for early intervention in this progressive eye disease.
Key Facts:
- early detection: iRORA lesions in early AMD cause significant localized vision loss.
- Advanced Imaging: The high-resolution AOSLO technique reveals details of retinal damage.
- Improved monitoring: Early detection allows for better treatment and can prevent severe vision loss.
sauce: University of Bonn
A new study from University Hospital Bonn (UKB) in collaboration with the University of Bonn has revealed for the first time that certain early changes in patients with age-related macular degeneration (AMD) can lead to measurable, localized vision loss.
The findings could help improve the treatment and monitoring of this eye disease in older patients, which gradually leads to central blindness, and test new therapies.
AMD primarily affects older adults. If left untreated, it can cause a gradual loss of central vision, significantly impairing everyday activities such as reading and driving. Researchers around the world are eager to find ways to detect and treat the disease early, before significant disability occurs.
The research team at UKB Eye Clinic, in collaboration with the University of Bonn and working closely with basic and clinical scientists, examined patients with specifically the early stages of AMD. The researchers focused on so-called iRORA lesions, which are very early anatomical signs of retinal damage.
Result is, BMJ Open Ophthalmology.
“To precisely measure the visual acuity in these damaged areas of the retina, we used microperimetry,” explain Julius Ameln, Dr. Marlene Sasmannhausen and Dr. Leon von der Emde, who carried out the tests.
This involves measuring the sensitivity of the retina to light stimuli to identify visual impairments. As the affected retinal area is less than 250 micrometers, regular clinical equipment is at its limit.
A high-resolution research instrument developed in Bonn called the Adaptive Optical Scanning Light Ophthalmoscope (AOSLO) can help.
“This enables us to image the retina with microscopic resolution and examine the function of small areas down to individual photoreceptors,” says Dr. Ulf Harmenning, Director of the AOSLO Laboratory at the UKB Eye Hospital and member of the Transdisciplinary Research Area (TRA) “Life and Health” at the University of Bonn.
The results were clear: vision in the affected areas was significantly reduced. By standard methods, the loss in vision was an average of 7 units compared to control areas. By the more precise AOSLO method, the loss in vision was 20 units, which corresponds to a 100-fold decrease in sensitivity to light.
These results indicate that iRORA lesions already have a significant impact on vision, and this early retinal damage may serve as an indicator to better monitor disease progression and treat it earlier.
The results of this study represent a further step towards a better understanding of how the late form of dry AMD develops with the formation of extensive retinal damage.
“Our studies show that even these early lesions can lead to a very localized but significant decrease in patients’ vision,” explains Dr. Wolf-Harmening.
“This makes it a potential marker that can help us better monitor the progression of AMD and treat it at an earlier stage,” adds Professor Frank Holtz, director of the UKB Eye Clinic.
About this visual neuroscience research news
author: Inca Vaz
sauce: University of Bonn
contact: Inca Verse – University of Bonn
image: Image courtesy of Neuroscience News
Original Research: Open access.
“Assessment of local susceptibility of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) lesions in intermediate age-related macular degeneration (iAMD)” Julius Ameln et al. BMJ Open Ophthalmology
Abstract
Assessment of local susceptibility of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) lesions in intermediate age-related macular degeneration (iAMD)
Incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) lesions are associated with disease progression in age-related macular degeneration, but the corresponding functional consequences of these precursor lesions are unknown.
In this study, we performed a cross-sectional study of four patients using microperimetry (MP) based on clinical-grade MAIA (stimulus size: 0.43°, approximately 125 µm) and adaptive optics scanning light ophthalmoscope (AOSLO, stimulus size 0.07°, approximately 20 µm) to evaluate the specific impact of iRORA pathology on retinal sensitivity.
AOSLO imaging showed an overall decrease in photoreceptor reflectance with patches of hyporeflective areas in drusen and scattered hyperreflective foci in iRORA areas. MAIA-MP showed a mean retinal sensitivity reduction of -7.3±3.1 dB in iRORA lesions compared with intraocular controls. In AOSLO-MP, the corresponding sensitivity reduction was 20.1±4.8 dB.
We demonstrated that iRORA lesions are associated with severe impairment of retinal sensitivity. Larger cohort studies will be required to validate our findings.
