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Ellipsoid zone reflectivity as a functional imaging biomarker for age-related macular degeneration: a MACUSTAR study report

This study evaluated the functional relevance of relative ellipsoid zone reflectivity (rEZR) on spectral-domain optical coherence tomography as a structural biomarker for retinal integrity, focusing on its association with retinal function. Participants with age-related macular degeneration (AMD) an...

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Main Authors: Liermann, Yannick N. (Author) , Behning, Charlotte (Author) , Isselmann, Ben (Author) , Schmid, Matthias (Author) , Dunbar, Hannah M. P. (Author) , Luhmann, Ulrich F. O. (Author) , Finger, Robert P. (Author) , Schmitz-Valckenberg, Steffen (Author) , Holz, Frank G. (Author) , Pfau, Maximilian (Author) , Luu, Chi D. (Author) , Saßmannshausen, Marlene (Author) , Thiele, Sarah (Author)
Format: Article (Journal)
Language:English
Published: 20 June 2025
In: Scientific reports
Year: 2025, Volume: 15, Pages: 1-12
ISSN:2045-2322
DOI:10.1038/s41598-025-00735-7
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41598-025-00735-7
Verlag, kostenfrei, Volltext: http://www.nature.com/articles/s41598-025-00735-7
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Author Notes:Yannick N. Liermann, Charlotte Behning, Ben Isselmann, Matthias Schmid, Hannah M.P. Dunbar, Ulrich F.O. Luhmann, Robert P. Finger, Steffen Schmitz-Valckenberg, Frank G. Holz, Maximilian Pfau, Chi D. Luu, Marlene Saßmannshausen, Sarah Thiele on behalf of the MACUSTAR consortium
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Summary:This study evaluated the functional relevance of relative ellipsoid zone reflectivity (rEZR) on spectral-domain optical coherence tomography as a structural biomarker for retinal integrity, focusing on its association with retinal function. Participants with age-related macular degeneration (AMD) and controls from the MACUSTAR study underwent functional testing, including mesopic fundus-controlled perimetry, best-corrected visual acuity, low-luminance visual acuity, low-luminance deficit, Moorfields Acuity Test, and Pelli-Robson contrast sensitivity, along with spectral-domain optical coherence tomography imaging. Structural and functional data were analyzed globally and spatially aligned for topographic analysis. Linear-mixed effects models, adjusted for age, sex, and eccentricity of the rEZR, assessed associations between rEZR and functional metrics. A total of 275 eyes (early AMD, n = 34; intermediate AMD, n = 152; late AMD, n = 36; controls, n = 53) from 275 participants (mean ± standard deviation age: 71.1 ± 7.2 years; 63.3% female) were included. In global analyses, rEZR was associated with the mean average threshold in mesopic fundus-controlled perimetry (coefficient estimate 0.0492, 95% confidence interval 0.0190-0.0794, p = 0.0015), low-luminance visual acuity (coefficient estimate − 0.0015, 95% confidence interval − 0.0026 to − 0.0004, p = 0.0092), Moorfields Acuity Test (coefficient estimate 0.0092, 95% confidence interval − 0.0022 to − 0.0001, p = 0.0285), and Pelli-Robson contrast sensitivity (coefficient estimate 0.0030, 95% confidence interval 0.0015-0.0045, p = 0.0001). Topographic analysis further revealed an association of rEZR with mesopic retinal sensitivity (coefficient estimate 0.0065, 95% confidence interval 0.0026-0.0104, p < 0.0001). Higher outer retinal reflectivity is linked to better retinal function in AMD and controls, supporting its potential as a biomarker for retinal integrity and function.
Item Description:Mitglieder des the MACUSTAR consortium: H. Agostini, L. Altay, R. Atia, F. Bandello, P.G. Basile, C. Behning, M. Belmouhand, M. Berger, R. Finger und viele weitere
Gesehen am 02.10.2025
Physical Description:Online Resource
ISSN:2045-2322
DOI:10.1038/s41598-025-00735-7

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