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Masahiro Miura, Shuichi Makita, Yoshiaki Yasuno, Shinnosuke Azuma, Toshihiro Mino, Tatsuo Yamaguchi, Takuya Iwasaki, Hiroshi Goto; Objective evaluation of retinal pigment epithelium change in retinal pigment epithelium detachment with multi-contrast OCT. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5289.
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© ARVO (1962-2015); The Authors (2016-present)
To objectively evaluate the retinal pigment epithelium (RPE) change in retinal pigment epithelium detachment (PED) in age-related macular degeneration (AMD) with multi-contrast OCT (MC-OCT), which is capable of simultaneous measurement of OCT angiography, polarization-sensitive OCT and standard OCT images.
We evaluated 21 eyes with serous PED and 12 eyes with drusenoid PED. We developed a pixel-wise segmentation method for RPE-melanin using dataset from MC-OCT, and calculated OCT images of RPE-melanin-specific contrast (RPE-melanin specific OCT) to evaluate RPE change. RPE-melanin thickness maps were created by counting the number of pixels with RPE-melanin at each A-line in the 3D dataset, and were compared with autofluorescence images at 488 nm (SW-AF) and 785 nm (NIR-AF). Area of thickened RPE-melanin (> 50 μm) in PED was compared with area and maximum height of PED and log MAR best corrected visual acuity (BCVA).
Thickened RPE-melanin lesions (> 50 μm) in PED were detected in 20 of 21 eyes in serous PED and 10 of 12 eyes in drusenoid. RPE-melanin specific B-scan OCT images showed melanin accumulation at RPE band with intraretinal RPE-melanin migration at thickened RPE-melanin lesions. Mean areas of thickened RPE-melanin (mean±SD) were 0.22 ± 0.25 mm2 in serous PED, and 0.15 ± 0.13 mm2 in drusenoid PED. Areas of thickened RPE-melanin were well corresponding with hyper SW-AF area and hyper NIR-AF area. For the eyes with both serous PED and drusenoid PED, areas of thickened RPE-melanin in PED were significantly positively correlated with PED area, maximum height of PED and log MAR BCVA (P < 0.003). Multiple regression analysis showed area of thickened RPE-melanin in PED was related with maximum height of PED (β = 0.49, P =0.019) for serous PED, and related with log MAR BCVA (β = 0.81, P =0.026) for drusenoid PED.
Multimodal imaging analysis showed thickened RPE-melanin lesions in PED was derived from intraretinal RPE migration, and correlated with PED height or BCVA. RPE-melanin specific OCT is useful to objectively evaluate RPE changes in AMD.
This is a 2020 ARVO Annual Meeting abstract.
Multimodal imaging of serous PED in AMD.
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