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Savastano MC, Falsini B, Ferrara S, Scampoli A, Piccardi M, Savastano A, Rizzo S. Subretinal Pigment Epithelium Illumination Combined With Focal Electroretinogram and Visual Acuity for Early Diagnosis and Prognosis of Non-Exudative Age-Related Macular Degeneration: New Insights for Personalized Medicine. Transl Vis Sci Technol 2022; 11:35. [PMID: 35077530 PMCID: PMC8802010 DOI: 10.1167/tvst.11.1.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the correlation between functional visual acuity and focal electroretinograms (fERGs) and morphological abnormalities in the retinal pigment epithelium and outer retinal atrophy (RORA) assessed by subretinal illumination (SRI) parameter at optical coherence tomography (OCT) examinations as signs of early disease in early and intermediate non-exudative age-related macular degeneration (ne-AMD). Methods One hundred forty-one eyes of 74 patients were retrospectively evaluated. A subgroup of patients (34/74) had a follow-up of at least 1 year. The study included both cross-sectional and longitudinal analyses. All eyes were assessed by OCT to measure the macular outer nuclear layer thickness, extent of ellipsoid zone interruption, absence or presence of drusen/reticular pseudodrusen in the foveal and perifoveal fields, and the SRI area closest to the fovea. Additionally, fERGs were performed. Results In the cross-sectional analysis, visual acuity and fERG amplitude were correlated (P < 0.01) with the SRI area. The fERG amplitude was correlated (P < 0.01) with the extent of ellipsoid zone interruption and tended to be lower in reticular pseudodrusen compared with drusen. In the longitudinal analysis, fERG amplitudes and outer retinal thickness tended to decrease on average by 15% and 18%, respectively, after 1 year of follow-up. The baseline RORA area, but not fERG amplitude or visual acuity, significantly predicted with 77% accuracy (P < 0.01) morphological deterioration, which was determined by an increase in the RORA area after 1 year. Conclusions Functional visual acuity and its morphological correlations can be assessed in early and intermediate ne-AMD eyes. SRI, as a result of RORA, is a potential predictor of ne-AMD progression in a short-term follow-up. Translational Relevance SRI assessment, an objective method to measure RORA, is a potential biomarker for non-exudative AMD progression.
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Affiliation(s)
- Maria Cristina Savastano
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Benedetto Falsini
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Ferrara
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Scampoli
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Piccardi
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alfonso Savastano
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy.,Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
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Savastano MC, Falsini B, Cozzupoli GM, Savastano A, Gambini G, De Vico U, Minnella AM, Placidi G, Piccardi M, Rizzo S. Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration: Correlation with Macular Function. J Clin Med 2020; 9:jcm9092973. [PMID: 32942540 PMCID: PMC7564054 DOI: 10.3390/jcm9092973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/30/2020] [Accepted: 09/09/2020] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to investigate the relationship between the retinal pigment epithelium (RPE) and outer retina changes, expressed in terms of sub-RPE illumination (SRI) on optical-coherence tomography (OCT), and central retinal function, measured by visual acuity and focal electroretinogram (fERG), in patients with non-exudative age-related macular degeneration (neAMD). In this retrospective study, 29 eyes of 29 patients affected by early (24.14%), intermediate (41.38%), and advanced (34.48%) neAMD were evaluated. All enrolled eyes were studied with OCT to measure the total area of SRI, by using an automated standardized algorithm. Visual acuity and fERG were assessed. The area of SRI was negatively correlated with fERG amplitude (r ≤ −0.4, p ≤ 0.02) and best-corrected visual acuity (BCVA) (r ≤ 0.4, p ≤ 0.04). Our results indicate that the severity of retinal pigment epithelium and outer retina atrophy (RORA), indirectly quantified through the detection of SRI areas by commercial OCT algorithms, is correlated with central retinal dysfunction, as determined by visual acuity and fERG, supporting the combined use of structural exams and functional tests as valid tools to detect the extent of RPE and photoreceptors’ disruption.
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Affiliation(s)
- Maria C. Savastano
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Benedetto Falsini
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Grazia M. Cozzupoli
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-3408292884
| | - Alfonso Savastano
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Gloria Gambini
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Umberto De Vico
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Angelo M. Minnella
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Giorgio Placidi
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Marco Piccardi
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Stanislao Rizzo
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; (M.C.S.); (B.F.); (A.S.); (G.G.); (U.D.V); (A.M.M.); (G.P.); (M.P.); (S.R.)
- UOC Oculistica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Via G. Moruzzi 1, 56124 Pisa, Italy
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Told R, Palkovits S, Boltz A, Schmidl D, Napora KJ, Werkmeister RM, Haslacher H, Frantal S, Popa‐Cherecheanu A, Schmetterer L, Garhöfer G. Flicker-induced retinal vasodilatation is not dependent on complement factor H polymorphism in healthy young subjects. Acta Ophthalmol 2014; 92:e540-5. [PMID: 24863099 PMCID: PMC4225479 DOI: 10.1111/aos.12433] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 03/17/2014] [Indexed: 02/02/2023]
Abstract
Purpose The complement factor H (CFH) tyrosine 402 histidine (Y402H, rs1061170) variant is known to be significantly associated with age-related macular degeneration (AMD). Whether this genetic variant may impact retinal blood flow regulation is largely unknown. This study investigated whether flicker-induced vasodilation, an indicator for the coupling between neural activity and blood flow, is altered in subjects carrying the rs1061170 risk allele. Methods One hundred healthy subjects (aged between 18 and 45 years) were included in this study. Retinal blood flow regulation was tested by assessing retinal vessel calibres in response to stimulation with diffuse flicker light. Retinal vascular flicker responses were determined with a Dynamic Vessel Analyzer (DVA). In addition, genotyping for rs1061170 was performed. Results Eighteen subjects were homozygous for the risk allele C, 50 were homozygous for the ancestral allele T, and 31 subjects were heterozygous (CT). One subject had to be excluded from data evaluation, as no genetic analysis could be performed due to technical difficulties. Baseline diameters of retinal arteries (p = 0.39) and veins (p = 0.64) were comparable between the three groups. Flicker-induced vasodilation in both retinal arteries (p = 0.38) and retinal veins (p = 0.62) was also comparable between the three studied groups. Conclusions Our data indicate that homozygous healthy young carriers of the C risk allele at rs1061170 do not show abnormal flicker-induced vasodilation in the retina. This suggests that the high-risk genetic variant of CFH polymorphism does not impact neuro-vascular coupling in healthy subjects.
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Affiliation(s)
- Reinhard Told
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Stefan Palkovits
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Agnes Boltz
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Katarzyna J. Napora
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine Medical University of Vienna Vienna Austria
| | - Sophie Frantal
- Center for Medical Statistics Informatics and Intelligence Systems Medical University of Vienna Vienna Austria
| | | | - Leopold Schmetterer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
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Marangoni D, Falsini B, Piccardi M, Ambrosio L, Minnella AM, Savastano MC, Bisti S, Maccarone R, Fadda A, Mello E, Concolino P, Capoluongo E. Functional effect of Saffron supplementation and risk genotypes in early age-related macular degeneration: a preliminary report. J Transl Med 2013; 11:228. [PMID: 24067115 PMCID: PMC3850693 DOI: 10.1186/1479-5876-11-228] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 09/13/2013] [Indexed: 01/28/2023] Open
Abstract
Background To determine whether the functional effects of oral supplementation with Saffron, a natural compound that proved to be neuroprotective in early age-related macular degeneration, are influenced by complement factor H (CFH) and age-related maculopathy susceptibility 2 (ARMS2) risk genotypes. Methods Thirty-three early AMD patients, screened for CFH (rs1061170) and ARMS2 (rs10490924) polymorphisms and receiving Saffron oral supplementation (20 mg/day) over an average period of treatment of 11 months (range, 6–12), were longitudinally evaluated by clinical examination and focal electroretinogram (fERG)-derived macular (18°) flicker sensitivity estimate. fERG amplitude and macular sensitivity, the reciprocal value of the estimated fERG amplitude threshold, were the main outcome measures. Results After three months of supplementation, mean fERG amplitude and fERG sensitivity improved significantly when compared to baseline values (p < 0.01). These changes were stable throughout the follow-up period. No significant differences in clinical and fERG improvements were observed across different CFH or ARMS2 genotypes. Conclusions The present results indicate that the functional effect of Saffron supplementation in individual AMD patients is not related to the major risk genotypes of disease.
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Affiliation(s)
- Dario Marangoni
- Dipartimento di Scienze Otorinolaringoiatriche e Oftalmologiche, Universita' Cattolica del Sacro Cuore, Lgo F, Vito 1, 00168 Roma, Italy.
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