Abstract
Purpose :
To investigate the association between calcific nodules with progression in age-related macular degeneration (AMD) and examine their impact on visual function using microperimetry.
Methods :
This study involved 280 eyes from 140 participants with bilateral large drusen. Multimodal imaging (MMI) and microperimetry were performed at baseline, and then every 6 months for 3 years. Baseline optical coherence tomography (OCT) scans covering a 20°x20° region were used to identify calcific nodules, defined as a hyporeflective core within a drusenoid lesion. The area of drusenoid lesions containing calcific nodules seen on OCT scans was then measured on color fundus photographs (CFPs). The main outcome measures were progression to late AMD determined on MMI, and mean microperimetric sensitivity. The association between the extent of drusen with calcific nodules and these outcomes was then evaluated, with and without adjustment for potential confounders.
Results :
A total of 20 (7%) eyes from 12 (9%) individuals were found to have calcific nodules at baseline. The presence and extent of calcific nodules were significantly associated with an increased risk of progression to late AMD (P = 0.034) and lower microperimetric sensitivity at baseline (P = 0.006). However, these associations were no longer significant (P ≥ 0.200 for all) after adjusting for total drusen volume from OCT imaging, presence of pigmentary changes on CFPs, and age.
Conclusions :
The presence and extent of calcific nodules at baseline was not independently associated with an increased risk of progression in AMD or with lower microperimetric sensitivity, after adjusting for important confounders of AMD disease severity and risk of progression.
This is a 2021 ARVO Annual Meeting abstract.