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Serena Fragiotta, Alessandro Cutini, Leopoldo Spadea, Vittoria De Rosa, Pier Luigi Grenga, Mariella Salomone, Enzo M Vingolo; Predictive factors on spectral domain optical coherence tomography in neovascular age-related macular degeneration.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5210.
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to investigate risk factors predictive for the development of neovascular age-related macular degeneration (NVAMD) with spectral domain optical coherence tomography (SD-OCT).
Fifty eyes of 50 age-sex matched patients with stage 2 and 3 of the International grading system for age related macular degeneration (AMD) and a minimum follow-up of 24 months (mean follow-up time: 32.85±11.36 months) were retrospectively collected. During follow-up 25 eyes developed in NVAMD. Drusenoid pigment epithelial detachment (DPED), hyperreflective foci (HRF), integrity of external limiting membrane (ELM), inner segment ellipsoid portion/outer segment (IS/OS), RPE/Bruch’s membrane complex (RPE/B) and subfoveal choroidal thickness (CT) were analyzed at baseline and last follow-up (FUL). Odds ratio (OR) for neovascular lesion was calculated.
Mean CT was significantly thinner in NVAMD group at baseline (P=0.01) and at FUL (P=0.02). The presence of reticular pseudodrusen was not significant between groups (P=0.16). Lesions with HRF (OR, 18; 95% confidence interval [CI], 2.83-81.09), discontinuity of RPE/B (OR, 15.16; 95% CI, 1.92-167.98), and ELM (OR, 24.37; 95% CI, 3.82-155.45) were significant predictors of new onset NVAMD at FUL (progression time: 6.35±2.66 months). Also the discontinuity of IS/OS showed a positive association with NVAMD (OR, 3.40; 95% CI, 1.62-7.10). Although the presence of DPED was not significant (OR, 1.55; 95% CI, 0.11-20.61), the width of DPED was significantly larger in NVAMD than control group both at baseline (P=0.001) and FUL (P<0.001).
The presence of HRF and the integrity of RPE/B and ELM bands seems to be predictive factors of NVAMD. Moreover mean subfoveal CT was significantly thinner in NVAMD group than control group. CT may integrated the stratification of NVAMD progression risk. These findings provide important information about the natural history of choroidal neovascularization.
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