Abstract
Purpose :
Recently, a consensus nomenclature and definition for outer retinal atrophy in age-related macular degeneration(AMD), based upon optical coherence tomography(OCT) imaging was proposed. However, relatively little is known regarding the prevalence of these imaging features in fellow eyes of patients with neovascular AMD(nAMD). This is particularly of interest as new treatments may help to reduce the risk of progression to more advanced forms of AMD.
Methods :
A retrospective analysis included consecutive patients treated for nAMD in one eye who had drusen in the fellow eye with 3 year follow-up. All eyes were scanned with the Topcon 3DOCT-2000 using a 512×128 scan pattern. OCT data at baseline, month 12, month 24 and month 36 were evaluated for incomplete and complete retinal pigment epithelium and outer retinal atrophy(iRORA and cRORA) using definitions from the CAM study group and the development of macular neovascularization(MNV).
Results :
Seventy-nine consecutively treated patients between November 2013 and January 2014 who had nAMD were studied. Of these patients, 45 patients had nAMD in one eye and drusen in the fellow eye were available for analysis. There were 26 (57.8%) females, with a mean age (±SD) of 79.2 (±7.5) years. At baseline, 11 (24.4%) eyes had evidence of iRORA whereas 3 eyes (6.7%) had evidence of cRORA. By 36 months of follow-up, 12 eyes (26.7%) developed MNV and were excluded from the analysis of atrophy. In the remaining 33 eyes, iRORA was seen in 10 (30.3%) eyes at baseline, in 11 (33.3%) eyes, 8 (24.2%) eyes and 7 (21.2%) eyes respectively at 12, 24, and 36 months. cRORA was seen in 1 (3%) eyes at baseline, in 2 (6%) eyes, 6 (18.2%) eyes and 8 (24.2%) eyes respectively at 12, 24, and 36 months. Progression to iRORA in eyes without RORA at baseline was seen in 3 (13.6%) eyes. Progression to cRORA in eyes without RORA at baseline was seen in 1 (4.5%) eye. Progression from iRORA at baseline to cRORA by month 36 was seen in 6 (60%) eyes.
Conclusions :
Retinal pigment epithelium and outer retinal atrophy is a common finding on OCT imaging. Evidence of atrophy on OCT imaging was detected in over a third of eyes at baseline with the majority of these eyes showing progression of atrophy after 36 month follow-up. OCT based definitions of atrophy may have a role in identifying disease progression in clinical practice.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.