Associations between Macular OCT findings and Peripheral Changes in AMD

Abstract

Purpose : The significance of peripheral findings in age-related macular degeneration (AMD) is not well understood. This study aimed to assess the association between macular lesions in AMD seen on optical coherence tomography (OCT) and the presence ofperipheral changes.

Methods : Prospective, cross-sectional study. We recruited patients with AMD and a control group (>50 years) without any vitreoretinal disease. Color fundus photos were obtained and used for AMD classification (AREDS classification). OCT scans (Spectralis, 97 lines horizontal volume) were assessed by two graders for the presence of AMD-related structural abnormalities. Additionally, we obtained ultra-widefield (UWF) Optos photographs and fundus autofluorescence (FAF) images, which were assessed by two graders (masked to macular OCT outcomes) for the presence of peripheral changes in the perimacular, midperipheral, and far-peripheral zones. Multivariate mixed-effect logistic models (accounting for correlated outcomes between 2 eyes) were used for analyses.

Results : We included 128 eyes (n = 72 patients), 75% with AMD and the remainder controls. Accounting for age and AMD stage, the presence of hyper-reflective foci in the macula was associated with having perimacular drusen (ß = 1.77, P = .004), and the presence of subretinal fluid with midperipheral drusen (ß = -4.75, P = .01). Additionally, the presence of pigment epithelial detachments in the macula was associated with a midperipheral reticular pigment (ß = 2.66, P = .01) on Optos photographs, and a nummular decreased FAF pattern in the far peripheral zone (ß = 3.82, P = .02).

Conclusions : To our knowledge, we describe for the first time associations between AMD OCT macular findings and presence of peripheral lesions on optos imaging. Our ongoing work in a bigger cohort to further validate these findings, will further contribute to our understanding of peripheral changes in AMD and their clinical relevance.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.