Purpose:
The purpose of our study was to evaluate the vitreoretinal interface (VRI) and the morphological changes in eyes with geographic atrophy (GA) due to Age-related Macular Degeneration (ARMD). At present there is limited information on this subject area.
Methods:
One hundred eyes of one hundred patients were included in this cross-sectional study. Only patients with GA were enrolled. Fundus autofluorescence (FAF) and Spectral-Domain Optical Coherence Tomographic (SD-OCT) images were obtained using a Heidelberg Engineering Spectralis HRA+OCT®. In each eye studied; the VRI, traction, GA pattern and retinal cysts were investigated. Eyes were divided into 4 groups; Group 1 (G1) were eyes without VRI changes, G2 were eyes with Posterior Vitreous Detachment (PVD) but without traction, G3 were eyes with PVD and traction, lastly G4 contained eyes with traction but without PVD.
Results:
Sixty females and forty males were enrolled, with a mean age of 78 (SD=±7 years range 55-92 years). Fifty three percent of eyes showed abnormalities of the VRI, G1 accounted for 47%, G2 20%, G3 6% and G4 for 27%. G3 and G4 were further divided into subgroups whether the traction involved the central zone or the periphery. Traction in group 3 largely involved the central zone (83%) whereas the traction in G4 was mainly in the periphery (56%). Furthermore the GA pattern within each group was analysed. Overall the diffuse pattern accounted for 45% and was also the predominant phenotype in each group, 36% in G1, 60% in G2, 66% in G3 and 44% in G4. Retinal cysts were not present in the majority of eyes (78%) however in G3 50% had cyst and all were located in the central area.
Conclusions:
The results of this study indicate that many patients with GA have VRI changes, with traction occurring in 62% of those eyes. The majority of the traction occurs in the central area especially if PVD is present. The limitation of SD-OCT is that it can only detect PVD within the scanning area. The analysis of GA pattern showed that diffuse was the predominant phenotype. Furthermore, although retinal cysts were not present in most eyes with VRI changes, the occurrence rate was high in the central zone of G3. These results should improve our knowledge on VRI changes in patients with GA.
Keywords: age-related macular degeneration • imaging/image analysis: clinical