September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Inner nuclear layer thickness predicts geographic atrophy progression in age-related macular degeneration.
Author Affiliations & Notes
  • Andreas Ebneter
    Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
    Department of Clinical Research, University of Bern, Bern, Switzerland
  • Damian Jaggi
    Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
  • Sebastian Wolf
    Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
    Department of Clinical Research, University of Bern, Bern, Switzerland
  • Martin Zinkernagel
    Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
    Department of Clinical Research, University of Bern, Bern, Switzerland
  • Footnotes
    Commercial Relationships   Andreas Ebneter, None; Damian Jaggi, None; Sebastian Wolf, None; Martin Zinkernagel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 34. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Andreas Ebneter, Damian Jaggi, Sebastian Wolf, Martin Zinkernagel; Inner nuclear layer thickness predicts geographic atrophy progression in age-related macular degeneration.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):34.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : We performed a retrospective, longitudinal, observational clinical study to analyze inner retinal changes in patients with geographic atrophy (GA) and identified potential morphological predictors for disease progression.

Methods : One hundred eyes with GA (mean patient age ± SD: 79.2 ± 6.7 years) were assessed and compared to age-matched controls. Retinal layers on horizontal line scans through the fixation point, acquired with spectral-domain optical coherence tomography in tracking mode, were segmented manually (Figure 1, top). Zones of GA were defined based on choroidal signal enhancement from retinal pigment epithelium loss. An area of unaffected temporal retina was used as reference. The paired Student's t-test was used to compare atrophic areas with unaffected retina in the same eye and changes over time. Progression of GA was quantified on fundus autofluorescence images. Retinal layer changes were correlated with GA progression rate using Pearson correlation.

Results : 41 eyes with GA of 41 patients were included in the final analysis and compared to controls (n=16). The mean follow-up was 36.6 ± 18.6 months. Increased inner nuclear layer (INL) thickness was found in areas of GA (Figure 1, bottom left). INL thickness was inversely correlated with best-corrected visual acuity. Moreover, INL thickness in areas adjacent to GA was associated with progression rates (Pearson r = 0.48, Figure 2).

Conclusions : Findings demonstrate that atrophy of the retinal pigment epithelium-photoreceptor complex in GA is associated with INL thickening. We speculate that this layer thickness increase is caused by reactive Müller cell changes and dysfunction. INL thickness in the retina adjacent to areas affected by GA was associated with atrophy progression rates.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1: Near-infrared image (IR) and horizontal optical coherence tomography scan of an eye affected by geographic atrophy with corresponding analysis of inner nuclear layer (INL) thickness (bottom right), where TE = unaffected temporal zone, 'Atrophy' = area of geographic atrophy, 'fovea' = central 1mm subfield. Bottom left: Bar graph showing the average thicknesses of the INL for the geographic atrophy area (Atrophy) and the TE. Two-sided paired Student's t-test (n=41, ****: p ≤ 0.0001, whiskers = SEM).

Figure 1: Near-infrared image (IR) and horizontal optical coherence tomography scan of an eye affected by geographic atrophy with corresponding analysis of inner nuclear layer (INL) thickness (bottom right), where TE = unaffected temporal zone, 'Atrophy' = area of geographic atrophy, 'fovea' = central 1mm subfield. Bottom left: Bar graph showing the average thicknesses of the INL for the geographic atrophy area (Atrophy) and the TE. Two-sided paired Student's t-test (n=41, ****: p ≤ 0.0001, whiskers = SEM).

 

Figure 2: Atrophy progression vs. INL thickness in temporal zone immediately adjacent to the GA (Pearson correlation).

Figure 2: Atrophy progression vs. INL thickness in temporal zone immediately adjacent to the GA (Pearson correlation).

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×