Plasma and Urine Metabolites Associated with Microperimetric Retinal Sensitivity in Age-Related Macular Degeneration

Background: Best-corrected visual acuity (BCVA) is the current gold standard of retinal function measurement but is not affected in early and intermediate forms of age-related macular degeneration (AMD). Increasing evidence suggests that microperimetry is a sensitive measure of visual function. This study sought to analyze the associations between plasma and urine metabolites and microperimetry in AMD. Methods: We included data on 363 eyes (95 controls, 268 AMD). Microperimetry was performed in patients with or without AMD using the Macular Integrity Assessment (MAIA) microperimetry system, employing a 37-point full-threshold protocol. Plasma and urine samples were analyzed via ultra-high-performance liquid chromatography-mass spectrometry. Multilevel mixed-effects linear models were used to assess associations between the metabolites and retinal sensitivity. Statistical significance was determined by considering the number of independent tests that accounted for 80% of the variance (ENT80). Results: We identified two plasma and seven urine metabolites, which were significantly associated with mean retinal sensitivity in AMD, and the key results include metabolites in the lysine metabolism pathway. Conclusions: To our knowledge, we present the first assessment of the associations between plasma and urinary metabolites and retinal microperimetry sensitivity in AMD. This work can reveal more insight into the pathogenesis of AMD.