June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Optical Coherence Tomography (OCT) Risk Markers for Progression of Intermediate Age-Related Macular Degeneration (AMD) to Late AMD
Author Affiliations & Notes
  • Jeong W Pak
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Kenneth Taylor
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Samuel Whittier
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Andrew Dieu
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Rick Voland
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Barbara A Blodi
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Amitha Domalpally
    Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Jeong Pak None; Kenneth Taylor None; Samuel Whittier None; Andrew Dieu None; Rick Voland None; Barbara Blodi None; Amitha Domalpally None
  • Footnotes
    Support  Research to Prevent Blindness and a National Eye Institute Vision Research Core Grant (P30 EY016665) to UW-Madison
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1030 – F0277. doi:
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    • Get Citation

      Jeong W Pak, Kenneth Taylor, Samuel Whittier, Andrew Dieu, Rick Voland, Barbara A Blodi, Amitha Domalpally; Optical Coherence Tomography (OCT) Risk Markers for Progression of Intermediate Age-Related Macular Degeneration (AMD) to Late AMD. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1030 – F0277.

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

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Abstract

Purpose : Early detection of geographic atrophy (GA) is key in preventing progression from intermediate to late AMD. OCT biomarkers provide a novel means of identifying early GA. We aimed to identify the frequency and the predictive role of OCT biomarkers for AMD progression.

Methods : This is a retrospective cohort study performed at the Wisconsin Reading Center. We evaluated OCT and fundus photographs (FP) of 102 eyes of 65 participants at baseline and at 5-years. At baseline, multimodal assessment excluded Complete Retinal Pigment Epithelial Outer Retinal Atrophy (cRORA), late AMD and ungradable images, and 73 eyes of 45 participants with intermediate AMD were evaluated using OCT for presence/number of hyperreflective foci (HRF), largest drusen size, drusen volume, drusen with hyporeflective core, reticular pseudodrusen (RPD) and Incomplete Retinal Pigment Epithelial Outer Retinal Atrophy (iRORA). AMD severity level was graded from FP. At 5-years, cRORA and CNV were assessed from multimodal imaging as a measure of progression to late AMD.

Results : At baseline, HRF were seen in 40 eyes (55%) with a mean of 4 (SD 6.0) per eye. The mean largest drusen size in horizontal width was 0.64 (SD 0.44) mm and the mean drusen volume was 1.06 (SD 0.24) mm3. Hyporeflective drusen were found in 40 eyes (55%). RPD was present in 20 eyes (27%) with a mean RPD area of 4.1 (SD 10.8) mm2. iRORA was identified in 24 eyes (33%). Thirteen eyes were the AMD severity levels 1-5 (18%), while 60 eyes were the levels 6-8 (82%). At 5-years, 13% of eyes developed CNV and 37% cRORA. In a multivariate model, iRORA and all drusen characteristics were associated with development of cRORA with an adjusted odds ratio of 4.4 (95% CI 1.2,18).

Conclusions : OCT features of intermediate AMD can be reproducibly graded and serve as precursors for development of endpoints such as cRORA. iRORA and all drusen characteristics are associated with increasing AMD severity and are strong predictors of cRORA. It remains to be studied if some OCT-related features of iRORA may be more predictive of progression than others. Long term studies with larger sample size are required to understand these important harbingers to advance new therapies for AMD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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