Determinants of Visual Functions in Patients with Early and Intermediate Age-related Macular Degeneration: the PEONY study

In this study, we investigated the influences of retinal structural changes on photopic and scotopic visual functions. Participants aged 55 years or over with early or intermediate age-related macular degeneration (AMD) in at least one eye, and controls with healthy maculae and were included. Associations between visual functions and retinal structural changes were investigated using linear regression and survival analysis in all participants. Additional multivariable analyses were also performed in the control group and the AMD group. We found that the presence of refractile drusen and nascent geographic atrophy (nGA) and were associated with poorer BCVA, LLVA, and increased LLD (P < 0.05). In survival analysis, eyes with thicker subfoveal choroidal thickness (SFCT) had a higher hazard rate of rod intercept (hazard ratio, HR = 1.287), suggesting a decreased RIT. Eyes with nGA (HR = 0.260), drusen (HR = 0.208), refractile drusen (HR = 0.126), SDD (HR = 0.157) have a significantly lower hazard rate of rod intercept (i.e. increased RIT, P < 0.05). Among them, thinner SFCT (HR = 1.229), drusen (HR = 0.421), and SDD (HR = 0.167) were identified as independent factors associated with an increased RIT in the final multivariate model (P < 0.05). Given the associations between visual functions with outer retinal layers thickness and presence of established precursors of progression to advanced AMD, our findings serve as a strong foundation for future investigations into the relationships between retinal phenotypes and functional changes.