July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Longitudinal and spatial analysis of ellipsoid zone reflectivity by optical coherence tomography in eyes at high risk for development of late AMD
Author Affiliations & Notes
  • Sarah Thiele
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Ben Isselmann
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Maximilian Pfau
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Jennifer Nadal
    University of Bonn, Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany
  • Monika Fleckenstein
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Matthias Schmid
    University of Bonn, Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany
  • Frank G. Holz
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Steffen Schmitz-Valckenberg
    University of Bonn, Department of Ophthalmology, Bonn, Germany
  • Footnotes
    Commercial Relationships   Sarah Thiele, Bayer (R), Carl Zeiss MediTec (F), CenterVue (F), Heidelberg Engineering (F), Heidelberg Engineering (R), Novartis (F), Optos (F); Ben Isselmann, None; Maximilian Pfau, Carl Zeiss MediTec (F), CenterVue (F), Heidelberg Engineering (F), Novartis (F), Optos (F); Jennifer Nadal, None; Monika Fleckenstein, Alcon/Novartis (F), Alcon/Novartis (R), Bayer (F), Bayer (R), Carl Zeiss MediTec (F), CenterVue (F), German Research Foundation (DFG): FL 658/4-1 and FL 658/4-2 (F), Heidelberg Engineering (F), Heidelberg Engineering (R), Pending patent: US20140303013 A1 (P), Roche (C); Matthias Schmid, None; Frank Holz, Acucela (F), Acucela (C), Allergan (F), Appelis (C), Bayer (F), Bayer (C), Bioeq/Formycon (F), Boehringer-Ingelheim (C), CenterVue (F), Ellex (R), Geuder (C), Grayburg Vision (R), Heidelberg Engineering (F), Heidelberg Engineering (C), LinBioscience (C), NightStarX (F), Novartis (F), Novartis (C), Optos (F), Oxurion (C), Pixium Vision (F), Roche/Genentech (F), Roche/Genentech (C), Stealth BioTherapeutics (C), Zeiss (F); Steffen Schmitz-Valckenberg, Acucela (F), Alcon/Novartis (C), Alcon/Novartis (F), Alcon/Novartis (R), Allergan (C), Allergan (F), Allergan (R), Bayer (F), Bayer (R), Bioeq/Formycon (F), Bioeq/Formycon (C), Carl Zeiss MediTec (F), Carl Zeiss MediTec (R), CenterVue (F), Galimedix (C), Genentech/Roche (F), Genentech/Roche (R), Heidelberg Engineering (F), Katairo (F), Optos (F)
  • Footnotes
    Support  BONFOR GEROK Program, Faculty of Medicine, University of Bonn, Grant No O-137.0026
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3454. doi:https://doi.org/
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      Sarah Thiele, Ben Isselmann, Maximilian Pfau, Jennifer Nadal, Monika Fleckenstein, Matthias Schmid, Frank G. Holz, Steffen Schmitz-Valckenberg; Longitudinal and spatial analysis of ellipsoid zone reflectivity by optical coherence tomography in eyes at high risk for development of late AMD. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3454. doi: https://doi.org/.

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

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Abstract

Purpose : To investigate the ellipsoid zone (EZ) reflectivity by spectral-domain optical coherence tomography (SD-OCT) over time in eyes with high risk for conversion into late age-related macular degeneration (AMD).

Methods : Annual SD-OCT raster scanning (field size 20°x15°, distance between neighboring B-scans: 30µm) was prospectively acquired over a six years period in eyes with AMD in the context of the longitudinal observational ModiAMD study. Longitudinal reflectivity profile (LRPs) of the SD-OCT were obtained for each of the 145 B-scans with lateral averaging using segments of 10 pixel along the x-axis. The normalized peak intensity of the EZ was determined as the ratio between EZ and external limiting membrane (ELM) intensity. Segments with drusen were excluded from the analysis. Linear mixed-effects models were used to account for the nested structure of the data (multiple segments measured within each eye).

Results : Sixteen eyes of 16 patients of 68.6 ± 7.2 years ([mean ± SD] age) and 8 healthy eyes of 70.1 ± 6.9 years ([mean ± SD] age) were included in the analysis with a total of 812.000 and 58.000 data points, respectively. The position of the segment, the diagnosis (AMD vs. healthy eyes) as well as the follow-up time exhibited a significant effect on the normalized EZ reflectivity (p<0.05 for each explanatory variable). Hereby, the normalized EZ reflectivity was higher for more eccentric segments ([estimate ± standard error] +0.12 ± 0.001 (arbitrary units (a.u.)) per sqrt-degree) and significantly reduced for eyes with AMD (-0.29 ± 0.14 a.u.) compared to non-AMD. Further, the normalized EZ reflectivity decreased slightly, yet significantly with follow-up time (-0.008 ± 0.0003 a.u. per year).

Conclusions : Despite of systematically excluding all areas with AMD-specific localized lesions including drusen, we found significant differences between non-late stage AMD and age-similar normal eyes. The findings support the view of AMD as a widespread retinal disease beyond the obviously localized visible morphological features. In addition, the normalized EZ intensity decreases significantly in AMD eyes with no conversion into advanced disease manifestations over time. Further analysis of EZ intensity as a prognostic biomarker for development of late-stage AMD is warranted.

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

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