June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Growth of geographic atrophy in non-neovascular age-related macular degeneration measured using sub-RPE illumination on optical coherence tomography
Author Affiliations & Notes
  • Phuoc-Hanh Le
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sumit Sharma
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Amy Babiuch
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Peter K Kaiser
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Kimberly Baynes
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Cindy Chen
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Michael Ramos
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Kayvan Barekatain
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Megan Ann McDonald
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Danielle Burton
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sunil K. Srivastava
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Phuoc-Hanh Le, None; Sumit Sharma, Alimera (C), Allergan (C), Bausch and Lomb (C), Clearside (C), Eyepoint (C), Genentech (C), Regeneron (C); Amy Babiuch, None; Peter Kaiser, Allegro (C), Allergan (C), Alzheon (C), Annexon Biosciences (C), AsclepiX (C), Bausch and Lomb (C), Bayer (C), Biogen Idec (C), Boerenger Ingelheim (C), Carl Zeiss Meditec (C), Clearside Biomedical (C), Galimedix (C), Gemini Therapeutics (C), Glaukos (C), Innovent (C), iRenix (C), IvericBio (C), jCyte (C), Kanghong (C), Kodiak (C), NGM Biopharmaceuticals (C), Novartis (C), Oxurion (C), Regeneron (C), Regenxbio (C); Kimberly Baynes, None; Cindy Chen, None; Michael Ramos, None; Kayvan Barekatain, None; Megan McDonald, None; Danielle Burton, None; Justis Ehlers, Adverum (C), Aerpio (F), Aerpio (C), Alcon (F), Alcon (C), Allegro (C), Allergan (C), Allergan (F), Boehringer-Ingelheim (F), Genentech (F), Genentech (C), Leica (P), Leica (C), Novartis (C), Novartis (F), Regeneron (F), Regeneron (C), Santen (C), Stealth (C), Thrombogenics (F), Thrombogenics (C), Zeiss (C); Sunil K. Srivastava, Abbvie (C), Allergan (F), Bausch and Lomb (C), Eyepoint (F), Eyepoint (C), Eyevensys (C), Novartis (C), Regeneron (F), Regeneron (C), Santen (F), Zeiss (C)
  • Footnotes
    Support  This study was supported in part by the NIH-NEI P30 Core Grant (IP30EY025585), Unrestricted Grants from The Research to Prevent Blindness, Inc., and Cleveland Eye Bank Foundation awarded to the Cole Eye Institute.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 271. doi:
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      Phuoc-Hanh Le, Sumit Sharma, Amy Babiuch, Peter K Kaiser, Kimberly Baynes, Cindy Chen, Michael Ramos, Kayvan Barekatain, Megan Ann McDonald, Danielle Burton, Justis P Ehlers, Sunil K. Srivastava; Growth of geographic atrophy in non-neovascular age-related macular degeneration measured using sub-RPE illumination on optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2021;62(8):271.

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

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Abstract

Purpose : Geographic atrophy (GA) growth in patients with non-neovascular age-related macular degeneration (NNAMD) is often measured from color fundus photography (CFP) and fundus autofluorescence (FAF). There is limited research on using the native sub-RPE (retinal pigment epithelium) illumination on the Zeiss Cirrus system to estimate GA area. In this study we assessed the ability to measure progression of geographic atrophy using sub-RPE illumination as measured on optical coherence tomography.

Methods : This is a retrospective review of NNAMD patients and at least 2 year follow-up. One follow-up visit was chosen yearly throughout follow-up for analysis. GA area was measured using sub-RPE illumination area (IA) from the Advanced RPE Analysis feature of FORUM Viewer (Carl Zeiss Meditec, Inc.). This feature measures the area (mm2) exhibiting sub-RPE hyper-reflectance within a 2.5 mm radius from the fovea. Central subfield thickness (CST, μm) and logMAR visual acuity (VA) were also obtained for each visit.

Results : 1051 eyes of 529 patients were included in the study. 383 eyes (36.4%) converted to neovascular AMD. 790 NNAMD eyes were analyzed with a mean follow-up length of 5.4 years and a mean age of 77. Mean baseline measurements for IA, CST, and logMAR VA were 1.81 mm2, 252.1 μm, and 0.34, respectively. The mean GA growth as measured by IA was 0.42 mm2/year. The mean change in CST was -3.48 μm/year, and the mean worsening of logMAR VA was 0.06/year.
Eyes were categorized into 5 subgroups by initial presentation of IA in mm2: 0-2 (n=575), 2-4 (n=88), 4-6 (n=45), 6-12 (n=65), and 12-18 (n=16). The mean growth rate of each subgroup was 0.37 mm2/year (±0.55), 0.73 mm2/year (±0.85), 0.53 mm2/year (±1.06), 0.50 mm2/year (±1.14), and 0.06 mm2/year (±0.67), respectively. Those exhibiting the highest IA growth rate (top 10%, n=79) had a mean growth rate of 1.88 mm2/year (±0.49).

Conclusions : Sub-RPE illumination area as measured on OCT can be used to estimate the growth of geographic atrophy in NNAMD. IA growth correlates with worsening in logMAR VA and reduction in CST. These measurements should be compared to the current gold standards of GA measurement to determine if it can be used as an outcome measure of clinical research.

This is a 2021 ARVO Annual Meeting abstract.

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