Identification of lesion components that influence visual function in age related macular degeneration
Open accessAbstract
AIMS: To explore the relation between lesion composition as assessed by fundus photography and fluorescein angiography with clinical measures of vision in eyes of patients with age related macular degeneration (AMD). METHODS: A standardised visual function assessment along with colour stereo pair fundus photography was carried out in both eyes of 58 subjects with a confirmed clinical diagnosis of AMD. The size, location, and composition of the macular lesion (blood, exudate, subretinal fluid, pigment, membrane, atrophy, and fibrosis) were measured on the colour photographs using computer assisted image analysis. Of the 58 subjects, 44 also had concurrent fluorescein angiography. Classic and occult choroidal neovascularisation (CNV), blood, blocked fluorescence, fibrosis, geographic atrophy, and the total area of abnormal fluorescence were measured. Multiple linear regression was used to examine the relation between clinical measures of vision and the location and extent of lesion components identified by both colour and fluorescein image capture. RESULTS: The composition of the macular lesion strongly influenced visual function, with atrophy (p=0.001) and fibrosis (p=0.002) accounting for most of the variation. When the location of the lesion with respect to the fovea was examined, fibrosis within the fovea significantly influenced all clinical measures of vision (p=0.008). The regression model selected the total area of abnormal fluorescence and a composite parameter (a semiquantitative measure of the following characteristics: atrophy, exudates, blood, and fibrosis ) from colour photography (r(2) =0.52) as the variables that explained most of the variation in clinical measures of vision. CONCLUSIONS: The composition and extent of the macular lesion strongly influences visual function in eyes with AMD. Both colour photography and angiography yielded information, which together explained considerably more of the variation in the clinical measures of vision than either on its own.
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Scar and atrophy are the two most important morphological features affecting visual outcomes in untreated nAMD and in anti-VEGF-treated patients.
“Scar and atrophy are the two most important morphological features that influence visual outcomes in untreated nAMD as well as in patients treated with anti-VEGF intravitreal injections.6,7”
From Development and Course of Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials (2018) · cites this paper as [7]
The Discussion reports that fibrosis (scarring) and atrophy strongly influenced visual function, more than blood or exudate. But Subjects and Methods says the measurements were taken at baseline, when none of the patients had received interventional therapy to the presenting eye. This paper therefore does not support the claim about patients treated with anti-VEGF injections. (LLM, conf=0.90)
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“Scar and atrophy are the 2 most important morphologic features that influence visual outcomes in untreated nAMD, as well as in patients treated with anti-VEGF intravitreal injections.(6,7) Scars thicker than 0.”
- Authors
- Hogg, R.
- Affiliations
- Queen's University Belfast (GB)
- Corresponding author
- Hogg, R
- ORCID
- Hogg, R
- Venue
- British Journal of Ophthalmology
- Publisher
- BMJ
- Published
- 2003-05-01
- Volume
- 87
- Issue
- 5
- Pages
- 609-614
- ISSN
- 0007-1161 (ISSN-L)
- PMC
- PMC1771654
- OpenAlex
- W2127112848
- Cited by
- 60
- References
- 16
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 1 · 2021: 3 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2014: 3 · 2013: 3 · 2012: 6
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Ophthalmology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Funders
- Queen's University Belfast
- Ulster University
- Queen's University
- Medical Research Council
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- age-related macular degeneration, visual function, choroidal neovascularization, geographic atrophy, fibrosis, subretinal fluid, exudate, fundus photography, fluorescein angiography, lesion localization, fovea
- MeSH terms
- Aged, Aged, 80 and over, Eye, Female, Fibrosis, Fluorescein Angiography, Fovea Centralis, Humans, Macula Lutea, Macular Degeneration, Male, Middle Aged, Optic Atrophy, Reading, Regression Analysis, Vision, Ocular, Visual Acuity, Contrast Sensitivity, Choroidal Neovascularization
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