MULTIMODAL IMAGING FINDINGS AND MULTIMODAL VISION TESTING IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Purpose: To investigate the interactions among multimodal imaging findings and multimodal vision testing in neovascular age-related macular degeneration. Methods: Patients enrolled in a prospective study of neovascular age-related macular degeneration with at least 3 previous intravitreal anti-vascular endothelial growth factor injections. Each patient underwent multimodal fundus imaging including spectral domain optical coherence tomography and fundus autofluorescence, and multimodal vision testing, including visual acuity, contrast sensitivity, reading speed, and microperimetry. Results: There were 73 eyes of 49 consecutive patients enrolled. Generalized estimating equations' modelling showed that the significant independent predictors of visual acuity were the area of confluent hypoautofluorescence and involvement of the foveal center with either granular or confluent hypoautofluorescence (P < 0.001). Contrast sensitivity was negatively correlated with the area of confluent hypoautofluorescence (P < 0.001), involvement of the foveal center with granular hypoautofluorescence (P = 0.017), and subfoveal choroidal thickness (P = 0.042). The only significant predictor of reading speed was the size of confluent hypoautofluorescence (P < 0.001). The size of the defect in the ellipsoid zone (P < 0.001) and the presence of intraretinal fluid (P = 0.045) were correlated with microperimetry score. Conclusion: Confluent absence of autofluorescence was a highly significant predictor of vision testing and serves as an easy parameter to obtain in patients with neovascular age-related macular degeneration.

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