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S. R. Freeman, I. Kozak, L. Cheng, D.-U. Bartsch, F. Mojana, N. Nigam, M. Brar, R. Yuson, W. R. Freeman; Relationship Between Spectral Domain OCT Determined Drusen Volume in AMD and AREDS Classification. Invest. Ophthalmol. Vis. Sci. 2009;50(13):940.
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Drusen are the hallmark of age-related macular degeneration (AMD) and substantial evidence exists that the amount of drusen and their effect on retinal pigment is a strong predictor of progression of AMD and vision loss. Until recently it was not possible to quantitate the volume of the drusen; however, the use of image stabilized scanning laser ophthalmoscope/spectral domain optical coherence tomography (SLO/ SD OCT) has enabled determination of drusen volume of this abnormal material. The purpose was to assess the correlation of drusen volume with Age-Related Eye Disease Study (AREDS) grade and drusen area in dry AMD.
36 eyes from patients with non-exudative AMD with visual acuity between 20/16 and 20/160 ETDRS were studied. Spectral Domain OCT/simultaneous OCT scans were taken as were color fundus photographs (35 degrees) of each eye. ETDRS visions were also recorded. The full AREDS Score excluding late stage AMD was determined by agreement between 2 trained observers. Drusen volume was determined by examination of a series of 96 SD OCT scans taken from arcade to arcade for a length of 6 mm. Volume was determined by calculating the drusen area in each scan and determining the drusen volume by calculating the effective volume of each cut using NIH Image J. Drusen were identified and outlined manually, not using an automated algorithm.
There was a strong and significant correlation between drusen volume and AREDS determined drusen area (p<0.0001, r=0.78). In addition, there was a correlation between AREDS classification and drusen volume (p=0.023, r=0.43) as determined by pair-wise correlation.
Drusen volume as determined by SD-OCT correlates with AREDS determined drusen area and AREDS grade in non-exudative AMD. The correlation is not perfect, however, as drusen area and volume average for 40% and 82% of the variation, respectively. Spectral Domain OCT determined drusen volume appears to provide additional information in grading severity of eyes with dry AMD.
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