July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Macular thinning occurs in Non-Advanced Age-related Macular Degeneration (AMD) and varies with AMD Stage and Subretinal Drusenoid Deposit (SDD) Presence
Author Affiliations & Notes
  • TsunKang "Trent" Chiang
    National Institutes of Health, Bethesda, Maryland, United States
    Case Western Reserve University School of Medicine, Cleveland Heights, Ohio, United States
  • Tiarnan D L Keenan
    Division of Epidemiology and Clinical Applications, National Eye Institue, Bethesda, Maryland, United States
  • Jennifer Liao
    Pennsylvania State University College of Medicine, Pennsylvania, United States
  • Brandon Klein
    Georgetown University School of Medicine, District of Columbia, United States
  • Emily Y Chew
    Division of Epidemiology and Clinical Applications, National Eye Institue, Bethesda, Maryland, United States
  • Catherine A Cukras
    National Eye Institute, National Institutes of Health, Maryland, United States
  • Wai T Wong
    National Eye Institute, Unit on Neuron-Glia Interactions, Maryland, United States
  • Footnotes
    Commercial Relationships   TsunKang "Trent" Chiang, None; Tiarnan Keenan, None; Jennifer Liao, None; Brandon Klein, None; Emily Chew, None; Catherine Cukras, None; Wai Wong, None
  • Footnotes
    Support  NIH Medical Research Scholars Program
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1182. doi:https://doi.org/
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      TsunKang "Trent" Chiang, Tiarnan D L Keenan, Jennifer Liao, Brandon Klein, Emily Y Chew, Catherine A Cukras, Wai T Wong; Macular thinning occurs in Non-Advanced Age-related Macular Degeneration (AMD) and varies with AMD Stage and Subretinal Drusenoid Deposit (SDD) Presence. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1182. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : While prominent degenerative retinal changes have been characterized in atrophic and exudative advanced AMD, it is less understood whether degenerative changes occur in eyes with early to intermediate AMD . Characterization of non-advanced AMD progression has largely focused on drusen and pigmentary changes, and changes in retinal thickness are not well characterized. We examined eyes with non-advanced AMD to discover AMD-related factors influencing macular thickness and thickness change over a 4-year period.

Methods : 143 eyes of 143 patients >50 years old ranging from no to intermediate AMD were imaged with optical coherence tomography with and without enhanced depth imaging at study baseline and 79 of these were re-imaged at 4 years. Macular thickness within the ETDRS fields, choroidal thickness (CT), and choroidal vascularity index (CVI) were measured. Study eyes were stratified into the following groups: control eyes with no large drusen (Group 1, N=35), eyes with large drusen but none in the fellow eye (Group 2, N=27), eyes with large drusen and large drusen or advanced AMD in the fellow eye (Group 3, N=60), eyes with SDD (Group SDD, N=20). Multivariate analyses using mixed models were performed to study the association between macular thickness, demographics and AMD features.

Results : On cross-sectional analyses , decreased macular thicknesses in the central 1mm and 3mm diameter areas were significantly associated with increased age and female sex. Group 3 (P<0.05) and Group SDD (P<0.01) had macular thickness measures that were significantly less than those of control eyes (Group 1). On longitudinal analyses, macular thinning in the central 1mm and 3mm diameter areas (measured as % decrease over 4 years) was greater in Group 3 (P<0.01) and Group SDD (P<0.001) relative to control Group 1 eyes . Macular thickness measures were not associated with choroidal parameters in multivariate analyses.

Conclusions : Decreases in macula thickness is not limited to eyes with advanced AMD but can occur during intermediate AMD. Rate of thinning is significantly accelerated with greater AMD severity and SDD presence but is independent of choroidal status. Macular thinning in intermediate AMD may be revealing of AMD pathobiology and constitute an outcome measure for clinical trials of AMD.

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

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