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Giulia Corradetti, Federico Corvi, Muneeswar Nittala, Srinivas R Sadda; Risk Factors for Development of iRORA in Eyes with Nonneovascular Intermediate Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1930.
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To evaluate the relationship between optical coherence tomography (OCT) features and demographic characteristics on the development of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) in eyes with nonneovascular intermediate age-related macular degeneration.
Fifty eyes from fifty subjects with nonneovascular intermediate age-related macular degeneration and no history of atrophy or macular neovascularization (MNV) in the study eye, were enrolled in this retrospective cohort study. OCT B-scans data and electronic medical records were reviewed for all subjects. The visit with first evidence of intermediate age-related macular degeneration on OCT was labeled as “baseline”. Baseline OCT B-scans from the study eye were annotated for previously described high-risk biomarkers including intraretinal hyperreflective foci (IHRF), subretinal drusenoid deposits (SDD), hyporeflective foci within core drusen (hDC), while the fellow eye was assessed for presence of atrophy and/or MNV. Electronic medical records were reviewed for socio-demographic characteristics including age, gender, ancestry, use of AREDS supplements and treatment with statins. OCT B-scans from the study eye obtained at month 6, 12, 18, 24, 30 and 36 were reviewed by masked graders for evidence of incident iRORA. The appearance of iRORA was plotted as a survival curve over a period of 36 months. Cox proportional hazards regression analysis was used to assess the factors associated with the development of iRORA.
By month 36, 70% of eyes (35/50) demonstrated evidence of iRORA. The overall mean time to development of iRORA was 23.2 (1.4) months. Baseline socio-demographic factors showed no significant association with the development of iRORA. Among baseline OCT features, only IHRF showed a statistically significant assocation with the development of iRORA (HR 3.06; 95% confidence interval [CI] 1.69 – 7.94; p = 0.001).
A substantial proportion of intermediate eyes, particularly those with IHRF, can progress to demonstrate evidence of iRORA over a three year period. These findings may be of value in risk stratificaiton and study design in early intervention trials of dry AMD.
This is a 2021 ARVO Annual Meeting abstract.
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