title: Scotopic and Photopic Microperimetry in Patients With Reticular Drusen and Age-Related Macular Degeneration.
abstract: OBJECTIVE
  Clinical observations suggest that patients with age-related macular degeneration (AMD) have vision problems, particularly in dim light conditions. Previous studies on structural-functional analysis in patients with AMD with reticular drusen (RDR) have focused on photopic sensitivity testing but have not specifically assessed scotopic function.
  
  
  OBJECTIVE
  To evaluate retinal function by scotopic and photopic microperimetry in patients with AMD and a well-demarcated area of RDR.
  
  
  METHODS
  Prospective case series in a referral center of 22 eyes from 18 patients (mean age, 74.7 years; range, 62-87 years). The study was conducted from June 1, 2014, to October 31, 2014.
  
  
  METHODS
  With the use of combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging, retinal areas with RDR (category 1) and no visible pathologic alterations (category 2) were identified in each eye. Scotopic and photopic microperimetry (MP-1S; Nidek Technologies) was performed using a grid with 56 stimulus points.
  
  
  METHODS
  Comparison of mean threshold sensitivities for each category for scotopic and photopic microperimetry.
  
  
  RESULTS
  In all eyes, areas of category 1 showed a relative and sharply demarcated reduction of scotopic threshold values compared with areas of category 2, but only less-pronounced differences were seen for photopic testing. Statistical analysis in the 18 eyes in which the 1.0-log unit neutral density filter was applied revealed a difference of scotopic threshold values in areas of category 1 (mean, 13.5 dB [95% CI, 12.1-15.0]) vs category 2 (mean, 18.3 dB; [95% CI, 17.4-19.3] (P ≤ .001). For photopic testing, the mean threshold values were 16.8 dB (95% CI, 15.5-18.2) in category 1 and 18.4 dB (95% CI, 17.1-19.6) in category 2 (P = .03).
  
  
  CONCLUSIONS
  The results of this study suggest that rod function is more severely affected than cone function in retinal areas with RDR. This differential structural-functional correlation underscores the functional relevance of RDR in patients with AMD.
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Julia S
authors: JS
authors: Steinberg
authors: Institute of Ophthalmology, University College London, London, England.
authors: Fred W
authors: FW
authors: Fitzke
authors: Institute of Biostatistics, University of Bonn, Bonn, Germany.
authors: Rolf
authors: R
authors: Fimmers
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Monika
authors: M
authors: Fleckenstein
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Frank G
authors: FG
authors: Holz
authors: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors: Steffen
authors: S
authors: Schmitz-Valckenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055253:Color Vision / Q000502:physiology*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000503:physiopathology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D055254:Night Vision / Q000502:physiology*; D009887:Ophthalmoscopy; D020419:Photoreceptor Cells, Vertebrate / Q000502:physiology*; D011446:Prospective Studies; D015593:Retinal Drusen / Q000503:physiopathology*; D012684:Sensory Thresholds; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests