Structural and functional changes of the eye in cases of age-related macular degeneration

Abstract

This literature review explores how structural changes in the macula, captured with modern multimodal imaging, relate to functional visual loss in age-related macular degeneration (AMD). It focuses on key anatomical markers, drusen and subretinal drusenoid deposits, retinal pigment epithelium abnormalities, photoreceptor and ellipsoid zone disruption, choriocapillaris flow deficits, geographic atrophy, and macular neovascularization, and links them to specific measures of visual performance such as best-corrected and low-luminance visual acuity, contrast sensitivity, dark adaptation, microperimetry, reading speed, and binocular function. By synthesizing these structure-function relationships, the review aims to identify which combinations of imaging and functional tests best capture disease severity, predict progression, and serve as meaningful, patient-relevant endpoints for treatment and future therapeutic trials.