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Title:	Association between functional and structural changes in eyes with age related macular degeneration
Authors:	Rituparna Ghoshal (P73269)
Supervisor:	Sharanjeet Kaur, Professor. Dr.
Keywords:	Macular Degeneration Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia
Issue Date:	21-Jan-2020
Description:	The general aim of this study was to evaluate quality of life (QOL), as well as to determine association between visual functions and retinal morphology of subjects with age-related macular degeneration (AMD). The parameters measured were QOL (using the National Eye Institute -Visual Function Questionnaire-25 (NEI-VFQ-25) in Bahasa Malaysia); visual functions i.e. distance visual acuity using Early Treatment Diabetic Retinopathy Study (ETDRS) chart, near visual acuity and reading speed using UiTM Malay related word reading chart, and contrast sensitivity using the Pelli- Robson Chart. The quantitative retinal morphology parameters determined were the average of outer nuclear layers thickness and volume, retinal pigment epithelium thickness and volume, total retinal thickness and volume, outer retinal thickness and volume, central thickness, maximum and minimum thickness of central 1mm ETDRS grid using the Optical Coherence Tomography (OCT). Qualitative parameters assessed were integrity of the photoreceptor inner and outer segment junction, external limiting membrane and retinal pigment epithelium-Bruch membrane complex. A total of 100 AMD patients (mean age 68.77 years) were recruited. This study showed that 96 subjects had late AMD in at least one eye, among which 59 subjects had polypoidal choroidal vasculopathy (PCV). These subjects had mean NEI-VFQ-25 score of 66.95±13.07 and 68.58±12.46 respectively. Mean NEI-VFQ-25 score of naïve PCV patients increased significantly from 66.73±13.74 to 73.54±14.26 (p=<0.001) after 6 months of treatment. In early to intermediate AMD, distance visual acuity, contrast sensitivity and reading speed showed significant correlation with average retinal pigment epithelium thickness, average outer nuclear layer thickness and volume (r=>0.5, p<0.05) whereas near visual acuity showed good correlation with average outer nuclear layer volume and average pigment epithelium thickness (r>0.50). In typical neovascular AMD, average retinal thickness, centre thickness and centre maximum thickness showed good correlation with distance visual acuity, near visual acuity and contrast sensitivity (r>0.50, p=<0.05) whereas centre minimum thickness showed good correlation with distance visual acuity (r=0.56, p=<0.05). The mean distance visual acuity, near visual acuity and contrast sensitivity were significantly better when external limiting membrane and photoreceptor outer and inner segment junction were intact (p=<0.05). In PCV patients, distance visual acuity showed good correlation with average retinal thickness, average retinal volume, centre thickness (r>0.5); contrast sensitivity showed good correlation with all the OCT parameters (r>0.5) except centre minimum thickness (r = -0.398) whereas near visual acuity showed significant correlation with average retinal thickness (r=0.358), volume (r=0.374), and centre thickness (r=0.354).The mean distance visual acuity, near visual acuity and contrast sensitivity between three external limiting membrane and photoreceptor outer and inner segment junction status were significantly different (p=0.002 & 0.000; p=0.012 & 0.029; p=0.005 & 0.001 respectively). All visual functions and quantitative retinal morphology parameters improved significantly in PCV patients after 6 months treatment. History of cholesterol, polyp, sub retinal fluid, disrupted external limiting membrane, photoreceptor inner segment and outer segment junction at 1000 micron of fovea showed a negative impact on visual functions after 6 months treatment. Thus, this study reported a new perspective of QOL, visual functions and morphological parameters of AMD patients that can assist in diagnosis, treatment and monitoring of AMD and its subtypes.,Degree Of Doctor Of Philosophy (Optometry)
Pages:	128
Call Number:	9 Tesis WW270. G427a 2020
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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