Abstract
Purpose :
To investigate how optical coherence tomography (OCT) measured macular thickness of the retina and retinal pigment epithelial drusen complex (RPEDC) varies with intermediate age-related macular degeneration (iAMD) severity and the presence of subretinal drusenoid deposits (SDD).
Methods :
In this longitudinal prospective study (NCT01352975), we followed 158 eyes from 89 participants (mean age = 71.5 yr, stdev 8.77 yr), with a range of AMD severities, excluding advanced disease, for 5 years with multimodal imaging and grading performed by the Wisconsin reading center. We investigated correlations between the thickness of the RPEDC (RPE to Bruch’s membrane) and neurosensory retina (NSR = total retina – RPEDC) and AREDS severity grade and SDD presence in cross-section. We also investigated the correlation of longitudinal changes in macular thickness with AMD severity progression and SDD presence.
Results :
At baseline, 14 eyes with AREDS severity scale grades 5-8 were evaluated to have SDD, 34 eyes were in step 0 (control), and 112 eyes were in steps 1-8.
In the cross-sectional data, NSR measures in the 1mm and 3mm rings revealed that eyes with SDD were significantly thinner than eyes in step 0. Comparisons of RPEDC in the 1mm and 3mm rings revealed that eyes in later AMD steps (5-6 and 7-8) were significantly thicker than eyes in step 0. SDD eyes had thicker RPEDC measures in the 3mm ring.
Over 5 years, a subset of eyes in each AMD severity step progressed at least one step scale score. Longitudinal analysis in the 1mm and 3mm rings demonstrated that eyes in later AMD steps 7-8 that progressed and eyes with SDD underwent NSR thinning.
Eyes in steps 1-2 and 3-4 that progressed showed significant RPEDC thickening in the central 1mm ring, whereas eyes in steps 7-8 that progressed showed significant RPEDC thinning. In the 3mm ring, eyes in steps 3-4 showed significant RPEDC thickening, whereas eyes in steps 7-8 that progressed showed significant thinning.
Conclusions :
Macular thickness in iAMD varies with disease severity, disease severity progression, and the presence of SDD. NSR measures were thinner in eyes with SDD. Eyes in steps 7-8 that progressed in AMD severity demonstrated NSR thinning. Eyes in earlier steps (3-4) that progressed in AMD severity showed RPEDC thickening, while progression in steps 7-8 is was associated with RPEDC thinning. Future work will include multivariate analyses to associate AMD progression with OCT measured changes.
This is a 2021 ARVO Annual Meeting abstract.