Junctional sensitivity and atrophy progression rate of geographic atrophy secondary to age‐related macular degeneration

PURPOSE: To determine the relationship between the baseline junctional retinal sensitivity measured with microperimetry and the atrophy progression rate in eyes with geographic atrophy (GA) secondary to age-related macular degeneration. METHODS: In this prospective cohort study, patients with GA were examined with fundus autofluorescence (FAF) to determine the atrophy area at baseline and at follow-up of 13.1 ± 2.5 months in order to determine the atrophy progression rate. Microperimetry and optical coherence tomography (OCT) were evaluated at baseline. Microperimetry was superimposed on the baseline FAF image to determine mean junctional sensitivity. Multivariable linear regression was performed adjusting for age, presence of junctional intraretinal hyperreflective foci (HRF), subretinal drusenoid deposits (SDD) and FAF pattern. RESULTS: Fifty-six eyes with GA of 56 patients were included. There was a significant association between baseline junctional sensitivity and the atrophy progression rate in GA eyes (β, -8.84 μm/year/dB; 95% CI, -16.56 to -1.11; p = 0.026) tested with simple linear regression. However, when adjusting for age, structural factors and junctional FAF patterns in a multivariable linear regression model, the association between junctional sensitivity and atrophy progression rate was no longer statistically significant (β, -6.40 μm/year/dB; 95% CI, -16.04 to 3.25; p = 0.18). The diffuse trickling FAF pattern was independently and significantly associated with progression rate (p = 0.019). CONCLUSIONS: Microperimetric junctional sensitivity may have relevance in predicting atrophy progression rate in eyes with GA, although the FAF pattern may be of greater importance. Larger, longitudinal studies are necessary to further elucidate this relationship.