June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Quantification of the area of retinal pigment epithelium tears in age-related macular degeneration
Author Affiliations & Notes
  • Christoph Clemens
    Ophthalmology, University Eye Hospital, Muenster, Germany
  • Florian Alten
    Ophthalmology, University Eye Hospital, Muenster, Germany
  • Christine Baumgart
    Ophthalmology, University Eye Hospital, Muenster, Germany
  • Peter Heiduschka
    Ophthalmology, University Eye Hospital, Muenster, Germany
  • Nicole Eter
    Ophthalmology, University Eye Hospital, Muenster, Germany
  • Footnotes
    Commercial Relationships Christoph Clemens, Heidelberg Engineering (F), Novartis (F); Florian Alten, Novartis Pharma (F), Heidelberg Engineering (F); Christine Baumgart, None; Peter Heiduschka, None; Nicole Eter, Novartis (F), Bayer (R), Heidelberg Engineering (R), Sanofi Aventis (C), Allergan (C), Bausch and Lomb (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 6277. doi:
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      Christoph Clemens, Florian Alten, Christine Baumgart, Peter Heiduschka, Nicole Eter; Quantification of the area of retinal pigment epithelium tears in age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6277.

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

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Purpose: To compare different quantification tools based on confocal scanning laser ophthalmoscopy (cSLO) for assessment of retinal pigment epithelium (RPE) tear size.

Methods: cSLO fundus autofluorescence (FAF) and near-infrared reflectance (IR) imaging were performed in 23 patients with RPE tear after intravitreal injection for pigment epithelium detachment due to exudative age-related macular degeneration (AMD) at baseline and additionally in 11 patients after 5.1 ± 1.8 months follow-up. RPE tear area was measured by three independent readers using three methods: manually on cSLO FAF images, manually on cSLO IR images, and using a FAF-based semi-automated software. Tears were also subdivided into unilobar and multilobar tear patterns.

Results: Confidence intervals were 0.08 and 0.12 for FAF, 0.11 and 0.09 for FAF-based semi-automated software and 0.25 and 0.27 for IR for intraobserver (reader 1) and interobserver agreements (readers 1 and 2), respectively. The average values of the square errors of the quantification methods were 0.040 ± 0.033 mm2 (FAF), 0.035 ± 0.060 mm2 (software) and 0.187 ± 0.219 mm2 (IR). Mean area of RPE tears at baseline given as the average measurement of all three readers using FAF-based semi-automated software was 5.77± 4.62 mm2 (range 0.13-14.74 mm2). Follow-up measurements of unilobar RPE tears (8 patients) showed no change in lesion area size (0.14 ± 0.33 mm2), in contrast, multilobar RPE tears (3 patients) showed a progression in lesion area size of 1.80 ± 0.74 mm2.

Conclusions: Manual FAF-based and semi-automated FAF-based quantifications of RPE tears are accurate and reproducible and superior to manual IR-based measurement. RPE tear area quantification is clinically relevant regarding progression following further intravitreal treatment, particularly in multilobar RPE tears.

Keywords: 412 age-related macular degeneration • 701 retinal pigment epithelium • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  

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