June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Hyper-Transmission Defects Detected on En Face OCT Images are a Risk Factor for Nascent Geographic Atrophy in Eyes with Intermediate AMD
Author Affiliations & Notes
  • yingying shi
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Jin Yang
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • William J Feuer
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Giovanni Gregori
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Philip J Rosenfeld
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   yingying shi, None; Jin Yang, None; William Feuer, None; Giovanni Gregori, Carl Zeiss Meditec (P), Carl Zeiss Meditec (F); Philip Rosenfeld, Apellis (C), Apellis (I), Bayer (C), Biogen (C), Boehringer-Ingelheim (C), Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Chengdu Kanghong Biotech (C), EyePoint (C), Iveric bio (F), Ocudyne (C), Ocudyne (I), Ocunexus Therapeutics (C), Regeneron (C), Stealth BioTherapeutics (F), Valitor Verana Health (I)
  • Footnotes
    Support  P.J.R.: Research support – Carl Zeiss Meditec, Stealth BioTherapeutics, Iveric bio; Consultant – Apellis, Bayer, Biogen, Boehringer-Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, EyePoint, Ocunexus Therapeutics, Ocudyne, Regeneron; Equity– Apellis, Valitor Verana Health, Ocudyne. G.G.: Research support–Carl Zeiss Meditec; Patents–Carl Zeiss Meditec
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2552. doi:
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      yingying shi, Jin Yang, William J Feuer, Giovanni Gregori, Philip J Rosenfeld; Hyper-Transmission Defects Detected on En Face OCT Images are a Risk Factor for Nascent Geographic Atrophy in Eyes with Intermediate AMD. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2552.

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Abstract

Purpose : To determine if the detection of choroidal hyper-transmission defects (hyperTDs) on en face OCT images serve as a risk factor for the formation of nascent geographic atrophy (nGA) or GA in eyes with intermediate AMD (iAMD), we compared the onset and persistence of hyperTDs with the gold-standard detection of nGA using averaged OCT B-scans

Methods : Patients with bilateral large drusen were enrolled in a natural history study and imaged with both Spectralis SD-OCT (Heidelberg Engineering, Heidelberg, Germany) and Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA) instruments at 6-month interval over 36 months. The Spectralis SD-OCT B-scans were used to grade for nGA at the Centre for Eye Research Australia. En face Cirrus SD-OCT images were graded for the presence of hyperTDs in a masked fashion at the Bascom Palmer Eye Institute. HyperTDs with greatest linear dimensions (GLDs) ≥ 125µm were measured and tracked throughout all available visits. The size cut-off for persistent and non-persistent hyperTDs was determined based on baseline GLD measurements. Over 36 months, the association between these HTDs and the presence of nGA was assessed.

Results : A total of 157 eyes from 81 patients were available to be graded. At baseline, Cirrus SD-OCT scans were available on 133 eyes, and 39 hyperTDs from 27 eyes of 22 subjects were classified as either persistent (26 lesions) or non-persistent (13 lesions) over 36 months. Receiver Operating Characteristic curve analysis suggested hyperTDs with baseline GLDs above a threshold of 250µm to 300µm fulfilled the definition of persistent lesions. After grading the entire population of 157 eyes, a significant association (p < 0.001) was found between nGA gradings and the masked gradings of hyperTDs with GLD ≥ 250µm (OR, 14.5, 95% CI: 4.8, 54.0) or 300µm (OR, 15.2, 95% CI: 5.0, 56.7). HyperTDs with GLD ≥ 250 or 300µm had an excellent negative predictive value of ≥ 94%, but a poor positive predictive value (PPV) of ≤ 40% for detecting nGA. The poor PPV appeared to be due to the earlier detection of lesions that would become nGA.

Conclusions : Choroidal hyperTDs detected on en face SD-OCT images with a GLD ≥ 250µm or 300µm were strongly associated with the presence of nGA and may serve as a useful risk factor for the early detection of disease progression of iAMD to GA.

This is a 2021 ARVO Annual Meeting abstract.

 

 

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