June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Characterization and disease progression of intermediate age-related macular degeneration in the prospective, longitudinal natural history ModiAMD Study
Author Affiliations & Notes
  • Sarah Thiele
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Jennifer Nadal
    Institut for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
  • Maximilian Pfau
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Arno Goebel
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Monika Fleckenstein
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Matthias Schmid
    Institut for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
  • Frank G Holz
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Steffen Schmitz-Valckenberg
    Departement of Ophthalmology, University of Bonn, Bonn, Germany
  • Footnotes
    Commercial Relationships   Sarah Thiele, Carl Zeiss Meditec (F), Heidelberg Engineering (F), Optos (F); Jennifer Nadal, None; Maximilian Pfau, Carl Zeiss Meditec (F), Heidelberg Engineering (F), Optos (F); Arno Goebel, Carl Zeiss Meditec (F), Heidelberg Engineering (F), Optos (F); Monika Fleckenstein, Alcon/Novartis (C), Alcon/Novartis (F), Bayer (R), Carl Zeiss Meditec (F), Genentec/Roche (C), Genentec/Roche (F), Genentec/Roche (R), Heidelberg Engineering (F), Heidelberg Engineering (R), Optos (F); Matthias Schmid, None; Frank Holz, Acucela (F), Acucela (C), Allergan (F), Allergan (R), Bayer (F), Bayer (C), Bayer (R), Bioeq (F), Bioeq (C), Boehringer-Ingelheim (C), Carl Zeiss Meditec (F), Carl Zeiss Meditec (R), Genentech/Roche (F), Genentech/Roche (C), Genentech/Roche (R), Heidelberg Engineering (F), Heidelberg Engineering (C), Heidelberg Engineering (R), Merz (C), NightstarX (F), Novartis (F), Novartis (C), Novartis (R), Optos (F), Thea (C); Steffen Schmitz-Valckenberg, Alcon/Novartis (C), Alcon/Novartis (F), Allergan (F), Allergan (R), Bayer (F), Bayer (R), Carl Zeiss Meditec (F), Formycon (F), Genentech/Roche (C), Genentech/Roche (F), Genentech/Roche (R), Heidelberg Engineering (F), Heidelberg Engineering (R), Optos (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2329. doi:
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      Sarah Thiele, Jennifer Nadal, Maximilian Pfau, Arno Goebel, Monika Fleckenstein, Matthias Schmid, Frank G Holz, Steffen Schmitz-Valckenberg; Characterization and disease progression of intermediate age-related macular degeneration in the prospective, longitudinal natural history ModiAMD Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2329.

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

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Abstract

Purpose : To analyze eyes at high-risk for progression to late-stage AMD over a five year period in the context of a prospective, longitudinal natural history study (ModiAMD).

Methods : Ninety-eight eyes with intermediate AMD (AREDS stage 3 or 4) of 98 patients (mean age 73.1 ± 7.1 years, range 51-89 years) were included in the ModiAMD study at baseline. At baseline and annual study visits, best-corrected visual acuity was determined and multimodal imaging was performed according to standardized operating procedures including spectral-domain optical coherence tomography, color fundus photography, fundus-autofluorescence- and infrared-reflection imaging. GA was defined through multimodal criteria (FAF: hypofluorescent area >0.1mm^2 and corresponding ONL thinning and choroidal hypertransmission in SD-OCT) and/or AREDS criteria.

Results : Applying the multimodal criteria, 42 (42.9%) eyes progressed to late-stage AMD after five years: 7 patients after one year, 20 patients after two, 26 after three and 34 after four years. In 25 (59.5%) eyes chorioidal neovascularization (CNV) and in 17 (40.5%) eyes central geographic atrophy (GA) occurred. Risk factors for conversion to both late-forms included hyperpigmentations (p=0.027) and confluent drusen (p=0.04) at baseline. Of the 17 eyes with central GA development, preexisting paracentral GA progressed into the central subfield in 6 eyes, while 11 eyes developed de-novo GA. Yet based on AREDS criteria, only 7 of these 17 eyes would have been recognized as having developed central GA.

Conclusions : These findings are important for a better understanding of conversion rates and high-risk features for development of late-stage AMD. They confirm that morphological biomarkers are of particular prognostic value. Further, the results indicate that multimodal imaging may allow for earlier and more precise detection of vision-related disease manifestation.

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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