Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration

Purpose: To analyze the relationship between distance from geographic atrophy (GA) lesion borders and mesopic retinal sensitivity in age-related macular degeneration (AMD). Design: Exploratory analyses of the longitudinal microperimetry dataset from a recent phase II, prospective, single-arm, nonran...

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Main Authors: Souvick Mukherjee, PhD, Emily Vance, MPH, Leon von der Emde, MD, Thilaka Arunachalam, BS, Tharindu De Silva, PhD, Alisa T. Thavikulwat, MD, Christine Orndahl, PhD, Caroline Nyaiburi, MS, Maria Abraham, ScM, Keri Hammel, MS, SriniVas R. Sadda, MD, Emily Y. Chew, MD, Maximilian Pfau, MD, PhD, Wai T. Wong, MD, PhD, Brett G. Jeffrey, PhD, Tiarnán D.L. Keenan, BM BCh, PhD
Format: Article
Language:English
Published: Elsevier 2025-11-01
Series:Ophthalmology Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666914525001770
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author Souvick Mukherjee, PhD
Emily Vance, MPH
Leon von der Emde, MD
Thilaka Arunachalam, BS
Tharindu De Silva, PhD
Alisa T. Thavikulwat, MD
Christine Orndahl, PhD
Caroline Nyaiburi, MS
Maria Abraham, ScM
Keri Hammel, MS
SriniVas R. Sadda, MD
Emily Y. Chew, MD
Maximilian Pfau, MD, PhD
Wai T. Wong, MD, PhD
Brett G. Jeffrey, PhD
Tiarnán D.L. Keenan, BM BCh, PhD
author_facet Souvick Mukherjee, PhD
Emily Vance, MPH
Leon von der Emde, MD
Thilaka Arunachalam, BS
Tharindu De Silva, PhD
Alisa T. Thavikulwat, MD
Christine Orndahl, PhD
Caroline Nyaiburi, MS
Maria Abraham, ScM
Keri Hammel, MS
SriniVas R. Sadda, MD
Emily Y. Chew, MD
Maximilian Pfau, MD, PhD
Wai T. Wong, MD, PhD
Brett G. Jeffrey, PhD
Tiarnán D.L. Keenan, BM BCh, PhD
author_sort Souvick Mukherjee, PhD
collection DOAJ
description Purpose: To analyze the relationship between distance from geographic atrophy (GA) lesion borders and mesopic retinal sensitivity in age-related macular degeneration (AMD). Design: Exploratory analyses of the longitudinal microperimetry dataset from a recent phase II, prospective, single-arm, nonrandomized trial of oral minocycline for GA progression. Participants: Individuals with GA from AMD in ≥1 eye. Methods: Mesopic retinal sensitivity was assessed longitudinally with a fundus-guided microperimetry device at baseline, month 3, and every 6 months thereafter, using a custom T-shaped test pattern centered on the fovea. Individual test loci were superimposed on an aligned fundus autofluorescence image and distance from the closest GA lesion border (GA distance) was computed. The relationship between GA distance and retinal sensitivity was analyzed in study eyes using repeated-measures regression. Main Outcome Measures: Mesopic retinal sensitivity. Results: The study population comprised 26 study eyes from 26 participants (mean age 74.2 years). Retinal sensitivity of extralesional testing loci increased steeply, as a quadratic function, between 0° and 2.05° (i.e., knot at 2.05°; 95% confidence interval [CI] 1.26°–2.84°) of GA distance. Beyond 2.05°, it increased linearly and less steeply. In nonlinear analyses accounting for nesting, a significant effect of GA distance on retinal sensitivity was observed. For GA distances <2.05°, sensitivity increased quadratically by approximately 1.99 decibels (dB)/° (95% CI: 1.15, 2.83 dB/°; P < 0.001) or higher. For GA distances ≥2.05°, sensitivity increased at 0.56 dB/° (95% CI: 0.42, 0.70 dB/°; P < 0.001). There was also a significant effect of time on sensitivity (estimate: −0.07 dB/month; 95% CI: −0.08, −0.06 dB/month; P < 0.001). Conclusions: The results demonstrate a perilesional zone 2° (∼580 μm) around the GA border in which retinal sensitivity changes steeply according to GA distance. This zone presents an important focus for closer evaluation in interventional studies examining potential efficacy for the preservation or recovery of retinal function. With GA progression, decreased retinal sensitivity expands ahead of GA expansion itself, as an advancing wave. Overall, the degree and extent of decreased visual function beyond GA borders have important implications for the design of clinical trials, decision-making in clinical practice, and insights into AMD pathophysiology. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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spelling doaj-art-6e165f8c80e24f97b59162bb1bdd4ddf2025-08-20T03:38:24ZengElsevierOphthalmology Science2666-91452025-11-015610087910.1016/j.xops.2025.100879Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular DegenerationSouvick Mukherjee, PhD0Emily Vance, MPH1Leon von der Emde, MD2Thilaka Arunachalam, BS3Tharindu De Silva, PhD4Alisa T. Thavikulwat, MD5Christine Orndahl, PhD6Caroline Nyaiburi, MS7Maria Abraham, ScM8Keri Hammel, MS9SriniVas R. Sadda, MD10Emily Y. Chew, MD11Maximilian Pfau, MD, PhD12Wai T. Wong, MD, PhD13Brett G. Jeffrey, PhD14Tiarnán D.L. Keenan, BM BCh, PhD15National Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, MarylandThe Emmes Company, LLC, Rockville, MarylandThe Emmes Company, LLC, Rockville, MarylandThe Emmes Company, LLC, Rockville, MarylandThe Emmes Company, LLC, Rockville, MarylandDoheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles, Los Angeles, CaliforniaNational Eye Institute, National Institutes of Health, Bethesda, MarylandDepartment of Ophthalmology, University Hospital Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, SwitzerlandTiresias Biopharma Consulting LLC, Half Moon Bay, CaliforniaNational Eye Institute, National Institutes of Health, Bethesda, MarylandNational Eye Institute, National Institutes of Health, Bethesda, Maryland; Correspondence: Tiarnán D.L. Keenan, BM BCh, PhD, NIH, Building 10, CRC, Room 10D45, 10 Center Dr, MSC 1204, Bethesda, MD 20892-1204.Purpose: To analyze the relationship between distance from geographic atrophy (GA) lesion borders and mesopic retinal sensitivity in age-related macular degeneration (AMD). Design: Exploratory analyses of the longitudinal microperimetry dataset from a recent phase II, prospective, single-arm, nonrandomized trial of oral minocycline for GA progression. Participants: Individuals with GA from AMD in ≥1 eye. Methods: Mesopic retinal sensitivity was assessed longitudinally with a fundus-guided microperimetry device at baseline, month 3, and every 6 months thereafter, using a custom T-shaped test pattern centered on the fovea. Individual test loci were superimposed on an aligned fundus autofluorescence image and distance from the closest GA lesion border (GA distance) was computed. The relationship between GA distance and retinal sensitivity was analyzed in study eyes using repeated-measures regression. Main Outcome Measures: Mesopic retinal sensitivity. Results: The study population comprised 26 study eyes from 26 participants (mean age 74.2 years). Retinal sensitivity of extralesional testing loci increased steeply, as a quadratic function, between 0° and 2.05° (i.e., knot at 2.05°; 95% confidence interval [CI] 1.26°–2.84°) of GA distance. Beyond 2.05°, it increased linearly and less steeply. In nonlinear analyses accounting for nesting, a significant effect of GA distance on retinal sensitivity was observed. For GA distances <2.05°, sensitivity increased quadratically by approximately 1.99 decibels (dB)/° (95% CI: 1.15, 2.83 dB/°; P < 0.001) or higher. For GA distances ≥2.05°, sensitivity increased at 0.56 dB/° (95% CI: 0.42, 0.70 dB/°; P < 0.001). There was also a significant effect of time on sensitivity (estimate: −0.07 dB/month; 95% CI: −0.08, −0.06 dB/month; P < 0.001). Conclusions: The results demonstrate a perilesional zone 2° (∼580 μm) around the GA border in which retinal sensitivity changes steeply according to GA distance. This zone presents an important focus for closer evaluation in interventional studies examining potential efficacy for the preservation or recovery of retinal function. With GA progression, decreased retinal sensitivity expands ahead of GA expansion itself, as an advancing wave. Overall, the degree and extent of decreased visual function beyond GA borders have important implications for the design of clinical trials, decision-making in clinical practice, and insights into AMD pathophysiology. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.http://www.sciencedirect.com/science/article/pii/S2666914525001770Geographic atrophyMesopic microperimetryOutcome measuresRetinal sensitivityTransitional zone
spellingShingle Souvick Mukherjee, PhD
Emily Vance, MPH
Leon von der Emde, MD
Thilaka Arunachalam, BS
Tharindu De Silva, PhD
Alisa T. Thavikulwat, MD
Christine Orndahl, PhD
Caroline Nyaiburi, MS
Maria Abraham, ScM
Keri Hammel, MS
SriniVas R. Sadda, MD
Emily Y. Chew, MD
Maximilian Pfau, MD, PhD
Wai T. Wong, MD, PhD
Brett G. Jeffrey, PhD
Tiarnán D.L. Keenan, BM BCh, PhD
Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
Ophthalmology Science
Geographic atrophy
Mesopic microperimetry
Outcome measures
Retinal sensitivity
Transitional zone
title Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
title_full Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
title_fullStr Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
title_full_unstemmed Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
title_short Variation in Mesopic Retinal Sensitivity Relative to Distance from Geographic Atrophy in Age-Related Macular Degeneration
title_sort variation in mesopic retinal sensitivity relative to distance from geographic atrophy in age related macular degeneration
topic Geographic atrophy
Mesopic microperimetry
Outcome measures
Retinal sensitivity
Transitional zone
url http://www.sciencedirect.com/science/article/pii/S2666914525001770
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