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J. N. Leuschen, K. Winter, M. McCall, T. Hwang, S. Srivastava, W. Wong, T. Clemons, M. Harrington, C. Toth, A2A SDOCT Study Group; Baseline SDOCT Characteristics of AREDS2 Ancillary Study Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):106.
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There are no large population studies identifying macular characteristics of non-neovascular Age-related Macular Degeneration (AMD) using spectral domain OCT (SDOCT). Our goal is to identify the qualitative characteristics of baseline macular disease using SDOCT in eyes with non-neovascular AMD.
We analyzed visual acuity and SDOCT data from sets of 100 scans within a 10 x 10 mm area of the macula in eyes of 316 subjects from the Age-Related Eye Disease Study 2 (AREDS2) Ancillary SDOCT Study. We included one Level 3 AMD eye from each subject in our baseline analysis. SDOCT images were graded for presence or absence of the following pathologies: vitromacular attachment (VMA), epiretinal membrane (ERM), cystoid macular edema (CME), subretinal fluid (SRF), other subretinal lesion, RPE elevation (RPEE), and RPE atrophy. Drusen were graded based on subfoveal location, reflectivity, presence of a core, serous pigment epithelial detachment (PED), and overlying intraretinal focal high reflectivity, photoreceptor thinning, and haze. Prevalence of each retinal pathology was calculated for the overall population as well as for several subcategories of participants.
The mean ETDRS baseline acuity score was 80.5 (SD 8.0). The prevalence of retinal lesions ranged from drusen found in 99.4% of study eyes to subretinal fluid in 6.7% (21 eyes). The prevalence of drusen characteristics were medium reflectivity (98.7%), haze over RPEE (94.0%), PRL thinning above RPEE (92.4%), subfoveal (88.6%), focal high reflectivity above RPEE (52.5%), high reflectivity (50.6%), low reflectivity (42.7%), core present (27.9%), and serous PED (6.7%). Subfoveal drusen were associated with a lower VA score (p= 0.027).
Retinal disease in Level 3 AMD eyes can be defined qualitatively with SDOCT. VMA, PRL thinning, and some intra or subretinal fluid visible on SD OCT are not identifiable on color fundus photographs. Future studies will provide information on how these characteristics relate to risk of future disease progression.
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