Detection Of Late Age-Related Macular Degeneration Using SD-OCT In A Population-Based Setting: The Alienor Study

Abstract

 

Purpose:

 

We investigated the contribution of SD-OCT imaging for the detection of late neovascular and atrophic AMD in a population-based setting.

 

Methods:

 

The ALIENOR (Antioxydants, LipidesEssentiels, Nutrition and maladies OculaiRes) Study is a population-based epidemiological study on age-related eye diseases. In 2009-2010, 625 subjects, aged 75 years or more, had an eye examination, including non mydriatic retinal colour photographs and examination with Spectralis SD-OCT (Heidelberg, Germany). AMD was graded from retinal photographs in 5 exclusive groups: late neovascular AMD; late atrophic AMD (geographic atrophy); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (early AMD2); large soft distinct drusen alone or pigment abnormalities alone (early AMD1); no AMD. SD-OCT examinations were graded by a retina specialist for presence of atrophy and signs of neovascular AMD (subretinal fluid, subretinal tissue, pigment epithelium detachment, intra-retinal fluid). Graders of retinal photographs were masked to OCT interpretations, and vice versa. Gradable retinal photographs and SD-OCT examinations were available in 935 eyes.

 

Results:

 

Of 27 eyes classified as neovascular AMD on colour photographs, 24 (88.9 %) were also classified as neovascular AMD on SD-OCT examinations. Conversely, 16 of 40 eyes (40.0 %) classified as neovascular AMD on SD-OCT examinations were not detected on retinal photographs. Similarly, of 38 eyes classified as geographic atrophy on colour photographs, 30 (79.0 %) were also classified as atrophic AMD on SD-OCT examinations. Conversely, 19 of 49 eyes (38.8 %) classified as atrophic AMD on SD-OCT examinations were not detected on retinal photographs. Respectively 11.3% and4.5 % and only 0.3 % of eyes classified as early AMD2, early AMD1 and no AMD from retinal photographs were diagnosed as late AMD on SD-OCT examinations.

 

Conclusions:

 

Both retinal photographs and SD-OCT examinations give information for the detection of late AMD, but SD-OCT examinations appear markedly more sensitive. Use of SD-OCT examinations, which are quick and not invasive, may be useful for the detection of initiating late AMD lesions in subjects with signs of early AMD on retinal photographs.

 

Keywords: macula/fovea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina