Abstract
Purpose :
To evaluate optical coherence tomography (OCT)-based risk factors for progression to late Age-related macular degeneration (AMD) in a population-based of the elderly Amish.
Methods :
A total of 1339 subjects (2668 eyes) were enrolled in this multicenter, prospective, longitudinal, observational study as part of the population-based Amish eye study. 666 subjects (49.7%) returned for a two-year follow-up visit and underwent complete ophthalmic exam, OCT (Spectralis 20°X20°), infrared reflectance images (IR) & olor fundus photography. Baseline OCT images were reviewed for presence of drusen volume > 0.03 mm3 in the central 3mm ring, intraretinal hyperreflective foci (IHRF), hyporeflective drusen core (hDC), subretinal drusenoid deposits (SDD), drusenoid pigment epithelium detachment (PED), subfoveal choroidal thickness, drusen area, volume within 3, 5-mm circles centered on ovea. Presence of SDD/reticular pseudodrusen (RPD) were also evaluated on IR images, including in regions outside the OCT scan field. Two year follow-up images were evaluated for presence of late AMD (geographic atrophy/macular neovascularization). These features at baseline were correlated with 2-year incidence of late AMD development by logistic regression.
Results :
Twenty-one (1.5%) of 1332 eyes progressed to late AMD at 2 years. Mean age of study subjects was 65±10.17 (±SD) years and 410 were female. Univariate logistic regression showed drusen area, volume in 3 & 5-mm circles, subfoveal choroidal thickness, drusen volume ≥ 0.03 mm3 in 3-mm ring, SDD, IHRF, and hDC were all associated with an increased risk for development of late AMD (odds ratios (OR) and 95% confidence intervals shown in table 1). Multivariate regression model identified that drusen volume in the 3-mm circle (OR:2.59, p=0.049) & presence of IHRF (OR:57.06, p<0.001) remained as independent and significant risk factors for progression to late AMD.
Conclusions :
This population-based study confirms previous findings from clinic-based studies that high central drusen volume and IHRF are associated with an increased risk of progression to late AMD. These findings may of value in risk stratifying patients in clinical practice or identifying subjects for early intervention clinical trials.
This is a 2021 ARVO Annual Meeting abstract.