Abstract
Purpose: :
To characterize the natural history of drusenoid pigment epithelium detachments (PEDs) using spectral-domain optical coherence tomography (SD-OCT) imaging of eyes from patients with nonexudative age-related macular degeneration (AMD).
Methods: :
Retrospective chart review of all the patients of a single attending that underwent SD-OCT (Cirrus, Zeiss) during the last year at a tertiary referral center. Out of 528 patients, 134 patients were found to have dry AMD and 16 out of the 134 patients had drusenoid PEDs with at least 2 OCT time points. 14 eyes of the 14 patients were included in the analysis. Main outcome measures were best-corrected visual acuity (BCVA), greatest linear diameter (GLD), height and volume of the PED. All the measurements were done with the macular cube 512x128 protocol of the Cirrus OCT. Regarding the volume of the PED, difference equal or greater than 25% was defined as significant change, while PEDs with volume change less than 25% were considered stable. Statistical analysis was performed with Wilcoxon signed rank test.
Results: :
The mean follow-up of the patients was 15.2 months (6-33). The median GLD of the PEDs at the end of the follow-up was 1393.5 μm compared to 1098.7 μm initially (p=0.004). The median height of the PEDs at the last visit was 155.92 μm compared to 136.64 μm (p=0.49). The median BCVA decreased from 20/31 to 20/38 at the end of the follow-up. The volume of the PED increased in 57% of the eyes (8/14) and remained stable in 43% (6/14).
Conclusions: :
Imaging with SD-OCT showed that drusenoid PEDs increased or remained stable over time. There was also an associated slight decrease in visual acuity. An appreciation of the quantitative changes in drusenoid PEDs over time using SD-OCT imaging provides a novel strategy for following disease progression and for identifying novel clinical trial end points to be used when investigating therapies for the treatment of nonexudative AMD.
Keywords: age-related macular degeneration