4 years ago

Peripheral visual fields in ABCA4 Stargardt disease and correlation with disease extent on ultra-widefield fundus autofluorescence

To evaluate the disease extent on ultra-widefield fundus autofluorescence (UWF-FAF) in patients with ABCA4- Stargardt disease (STGD) and correlate this data with functional outcome measures. Design Retrospective cross sectional study Setting Kellogg Eye Center, University of Michigan Study population Sixty-five patients with clinical diagnosis and proven pathogenic variants in the ABCA4 gene. Observational procedures The UWF-FAF images were obtained using Optos 200- degrees and classified into three types. Functional testing included: kinetic widefield perimetry, full-field electroretinogram (ffERG) and visual acuity (VA). All results were evaluated with respect to UWF-FAF classification. Main outcome measures Classification of UWF-FAF; area comprising the I4e, III4e, and IV4e isopters; ffERG patterns; and VA. Results For UWF-FAF, 27 subjects (41.5%) were classified as type I; 17 (26.2 %) as type II; and 21 (32.4%) as type III. The area of each isopter correlated inversely with the extent of the disease and all isopters were able to detect differences among UWF-FAF types (IV4e, p = 0.0013; III4e, p = 0.0003; I4e, p < 0.0001= 3.93e-8). ffERG patterns and VA were also different among the three UWF-FAF types (p < 0.001= 6.61e-6 and p < 0.001= 7.3e-5, respectively). Conclusion Patients with widespread disease presented with more constriction of peripheral visual fields, had more dysfunction on ffERG and worse VA compared to patients with disease confined to the macula. UWF- FAF images may provide information for estimating peripheral and central visual function in STGD.

Publisher URL: www.sciencedirect.com/science

DOI: S0002939417304294

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