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Lili Grunwald, Stephanie Schuman, Jessica N. Leuschen, Katrina Winter, Michelle McCall, Wai T. Wong, Neeru Sarin, Molly Harrington, Emily Y. Chew, Cynthia A. Toth; Comparison of Spectral Domain Optical Coherence Tomography Characteristics of Intermediate Versus Advanced Age-related Macular Degeneration in AREDS2. Invest. Ophthalmol. Vis. Sci. 2011;52(14):159.
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To compare spectral domain optical coherence tomography (SDOCT) characteristics at baseline in eyes with intermediate versus advanced age-related macular degeneration (AMD) in the Age-Related Eye Disease Ancillary (A2A) SDOCT study. The goal of the A2A study is to identify whether SDOCT patterns such as: drusen size, OCT reflectivity within drusen, photoreceptor change over drusen, subretinal fluid or intraretinal cysts are predictive of vision loss and progression of AMD.
Prospective cross-sectional study of A2A subjects at cohort entry comparing intermediate and advanced AMD. SDOCT scan sets covering the entire macula (6.6 x 6.6 mm volume scan) were graded.
Lesions seen on SDOCT were compared between 465 eyes with intermediate AMD (level 3 AMD) and 166 eyes with advanced AMD (level 4 AMD). 36% and 46% of eyes in the intermediate and advanced AMD groups, respectively, had epiretinal membranes (p=0.02). In addition, 21% and 22% of intermediate and advanced AMD eyes, respectively, had vitreomacular attachment (p=0.41). SDOCT characteristics suggestive of fluid within or beneath the retina (subretinal and intraretinal fluid), retinal pigment epithelial (RPE) atrophy and drusen with low internal reflectivity were significantly more prevalent among the eyes classified as advanced AMD (all p values<0.0001). Foveal drusen, drusen with medium and high internal reflectivity, photoreceptor thinning above drusen (all p-values<0.0001), and presence of a core within drusen (p=0.02) were significantly more prevalent in eyes with intermediate AMD than eyes with advanced AMD. In addition, these SDOCT characteristics were compared between intermediate AMD and central geographic atrophy eyes, and between intermediate AMD and choroidal neovascularization eyes.
Advanced AMD eyes were more likely to have fluid within or beneath the retina, RPE atrophy, and drusen with low internal reflectivity. Rates of epiretinal membranes were high in all eyes. The wide spectrum of pathology on SDOCT may reflect different stages of the disease or different cellular and molecular changes. These patients will be followed over time to determine if SDOCT measures can be used to predict progression of AMD.
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