June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Implications of Drusen Burden on Optical Coherence Tomography Angiography Findings in Nonexudative Age-related Macular Degeneration in the AVATAR Study
Author Affiliations & Notes
  • Allison Watts
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Deepa Manjunath
    School of Medicine, Case Western Reserve Univeristy, Cleveland, Ohio, United States
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Rishi P Singh
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Peter K Kaiser
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Aleksandra V Rachitskaya
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Andrew Schachat
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Jamie Reese
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Justis Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Allison Watts, None; Deepa Manjunath, None; Rishi Singh, Alcon (F), Apellis (F), Genentech (C), Genentech (F), Optos (C), Regeneron (C), Regeneron (F), Shire (C), Zeiss (C); Sunil Srivastava, Alcon (C), Allergan (F), Bausch and Lomb (C), Bausch and Lomb (P), Bioptigen (P), Leica (P), Santen (C), Synergetics (P), Zeiss (C); Peter Kaiser, Allergan (C), Bayer (C), Novartis (C), Regeneron (C); Aleksandra Rachitskaya, Allergan (C); Andrew Schachat, None; Jamie Reese, None; Justis Ehlers, Alcon (C), Alcon (F), Alimera (C), Allergan (C), Bausch and Lomb (P), Bioptigen (C), Bioptigen (P), Genentech (C), Genentech (F), Leica (C), Leica (P), Regeneron (F), Santen (C), Synergetics (P), Thrombogenics (C), Thrombogenics (F), Zeiss (C)
  • Footnotes
    Support  NIH/NEI K23-EY022947-01A1; Ohio Department of Development TECH-13-059
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 38. doi:
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      Allison Watts, Deepa Manjunath, Rishi P Singh, Sunil K Srivastava, Peter K Kaiser, Aleksandra V Rachitskaya, Andrew Schachat, Jamie Reese, Justis Ehlers; Implications of Drusen Burden on Optical Coherence Tomography Angiography Findings in Nonexudative Age-related Macular Degeneration in the AVATAR Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):38.

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

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Abstract

Purpose : To assess the impact of drusen burden on optical coherence tomography angiography (OCT-A) findings in nonexudative age-related macular degeneration (AMD) for the detection of subclinical choroidal neovascularization (CNV).

Methods : AVATAR is an IRB-approved prospective observational study of OCT-A in eyes undergoing routine spectral-domain optical coherence tomography (SD-OCT) for macular disease. Patients were imaged with the Avanti RTVue XR HD (Optovue, Fremont, CA) and the Cirrus HD-OCT system (Zeiss, Oberkochen, Germany). The Avanti system was equipped with the SSADA algorithm software for OCT-A performance. Utilizing the advanced retinal pigment epithelium (RPE) analysis on the Cirrus review software, drusen burden was evaluated. “High" drusen burden was defined by an RPE elevation cross-sectional area ≥ 1mm2 on the 5 mm circle. “Intermediate” included eyes with a cross-sectional area between 1mm2 and 0.5mm2. “Low” was defined by cross-sectional area < 0.5 mm2. Additional clinical features were evaluated in addition to drusen anatomy. Masked review of the images was performed by an expert reader.

Results : Sixty-two eyes of 47 patients with nonexudative AMD were included in the analysis. Twenty-eight of 62 (45%) eyes had “high” drusen burden, 11/62 (18%) had “intermediate” drusen burden, and 23/62 (37%) had “low” drusen burden. On OCT-A review, 3/62 (4.8%) of study eyes were found to have definitive CNV. Of the three eyes with definitive CNV, one had high drusen burden, one intermediate drusen, and one low drusen burden. All study eyes with definitive CNV had a fellow eye with exudative AMD and was the only factor associated with the presence of subclinical CNV (p = 0.017).

Conclusions : In this study, CNV presence was independent of drusen burden, but was associated with the presence of CNV in the fellow eye. Utilizing OCT-A in high-risk patients may facilitate earlier detection of CNV in asymptomatic eyes and allow for closer surveillance of these patients.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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