Cicinelli, Maria Vittoria;
Montesano, Giovanni;
Berni, Alessandro;
Scandale, Pierluigi;
Ometto, Giovanni;
Introini, Ugo;
Parodi, Maurizio Battaglia;
... Marchese, Alessandro; + view all
(2024)
Photoreceptor Integrity in MEWDS: Longitudinal Structure-Function Correlations.
Investigative Ophthalmology & Visual Science
, 65
(4)
, Article 28. 10.1167/iovs.65.4.28.
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Abstract
Purpose: The purpose of this study was to investigate structure-function correlations in multiple evanescent white dot syndrome (MEWDS) using microperimetry (MP) and spectral-domain optical coherence tomography (SD-OCT). // Methods: Single-center prospective observational study including 14 eyes from 13 patients with MEWDS monitored over a median of 49.5 days (interquartile range = 29–92 days). Investigations focused on best-corrected visual acuity (BCVA), foveal granularity, and the Photoreceptor Reflectivity Ratio (PRR) as a measure of photoreceptor integrity. MP assessed average retinal threshold sensitivity (RTS) and bivariate contour ellipse area (BCEA) for fixation stability. A linear mixed model was used to test associations and interactions among RTS, time, and clinical variables. A hierarchical linear mixed model was used to analyze structure-function relationships, addressing both individual and location-specific variations. // Results: Overall, 2340 MP locations were tested. PRR revealed a transient decrease within 30 days post-presentation, indicative of early photoreceptor disruption, followed by a progressive increase, signaling recovery. Significantly lower foveal sensitivity (RTS = 14.8 ± 7.4 vs. 22.5 ± 4.4 decibel [dB], P = 0.04) and increased fixation spread (63% BCEA = 1.26 ± 0.97 vs. 0.48 ± 0.35 deg2, P = 0.06) were noted in eyes with foveal granularity compared to those without. A significant increase in RTS was demonstrated over time (0.066 dB/day, P < 0.001), with a central-to-peripheral gradient of improvement. The interaction between follow-up time and baseline BCVA (P < 0.001) indicated more rapid improvement in eyes with worse initial vision. There was a robust, nonlinear association between PRR and RTS across all tested locations (P < 0.001), becoming asymptotic for sensitivity losses exceeding 20 dB. // Conclusions: Photoreceptor reflectivity accurately aligned with visual function in MEWDS on longitudinal examinations. The central-to-peripheral gradient of improvement may suggest specific vulnerabilities underlying the area around the disc.
| Type: | Article |
|---|---|
| Title: | Photoreceptor Integrity in MEWDS: Longitudinal Structure-Function Correlations |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1167/iovs.65.4.28 |
| Publisher version: | http://dx.doi.org/10.1167/iovs.65.4.28 |
| Language: | English |
| Additional information: | Copyright 2024 The Authors. This work is licensed under a Creative Commons Attribution 4.0 International License, https://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Multiple evanescent white dot syndrome (MEWDS), microperimetry, spectraldomain optical coherence tomography (SD-OCT), photoreceptor reflectivity ratio (PRR), retinal threshold sensitivity (RTS), foveal granularity |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10192288 |
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