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Julia Lemke, Vasilena Sitnilska, Eveline Kersten, Tina Schick, Philip Enders, Carel C B Hoyng, Anneke I Den Hollander, Sascha Fauser, Lebriz Altay; Progression to late AMD: Role of SDOCT-biomarkers in patients with drusenoid PED. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2377.
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To evaluate the role of hyperreflective foci (HF) and reticular drusen (RD) for progression to late age-related macular degeneration (AMD) in high-risk patients with drusenoid PED (dPED).
This case-control study included 73 patients with dPED due to AMD, without any signs of choroidal neovascularization (CNV) or central geographic atrophy (GA), from European genetic database with follow-up of at least 5 years. DPED was defined as a well-defined large druse ≥360µm detected on color fundus photographs (FP) and spectral-domain optical coherence tomography (SDOCT). Grading was performed for AMD, for presence of HF (≥10 lesions with reflectivity equal/higher than the retinal pigment epithelium) and for RD. Logistic regression analysis for development of late AMD included age, gender, smoking, HF and RD.
During a mean follow-up time of 6.13±1.12 years (range 4.5-10.4 years), 40 of 73 patients (54.8%) developed late AMD (CNV n=12, GA n=20, mixed type n=8). DPED patients with either RD (Odds ratio (OR)=6.79, 95% Confidence interval (CI): 0.79-58.33, p=0.081) or HF (OR=4.60, 95% CI:1.40-15.12, p=0.012) showed increased likelihood of developing late AMD after 5 years in comparison to dPED patients without these features. The association of presence of HF in dPED patients and the development of late AMD was still significant after adjusting for age, gender and smoking (OR=4.71, 95% CI:1.09-20.30, p=0.038), whereas RD were not predictive (p=0.81).
Patients with simultaneous occurrence of dPED and ≥10 HF in SDOCT have an increased likelihood of progression to late AMD during 5 years. In those cases intensified monitoring seems advisable to detect conversion and treat as early as possible.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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