Morphological outcomes in fellow eyes of patients with exudative AMD after 10 years of follow up: progression rates and OCT risk factors.

Abstract

Purpose : To determine the 10-year morphological outcomes and progression to exudative AMD in the fellow eyes (FE) of patients with naïve exudative AMD.

Methods : Data from 52 patients with naïve exudative AMD in one eye and at least 10 years of follow-up were retrospectively reviewed. Baseline optical coherence tomography (OCT) features as presence and type of drusen and non-foveal atrophy, central retinal thickness, subfoveal choroidal thickness and presence of intraretinal hyperreflective foci (iHRF) were acquired in the FEs; macular neovascularization (MNV) type was also assessed in the exudative AMD eye. Choroidal vascularity index of the FE was calculated in a region of 1500 µm centered at the fovea. Time and rate of progression of the FEs into exudative AMD were examined by Kaplan-Meier analysis and Cox regression.

Results : Twenty-eight FEs (53.8%) developed exudative AMD within the 10-year follow-up. An earlier progression to exudative AMD was associated with the presence of iHRF (47.625 vs 108.647 months, p=0.014), Subretinal Drusenoid Deposits (SDD) and Cuticular drusen (43.0 and 47.6 vs 90.2 months respectively, p<0.001) at baseline. Cuticular drusen were furthermore associated with a higher risk of developing an exudative MNV (Hazard Ratio [HR] 9.137; 95% confidence interval [CI] 1.643 – 50.818, p=0.023). Type 3 MNVs in the exudative AMD eye significantly associated with early MNV development in the FE (40.51 months; 95% CI 10.921 – 70.222, p=0.041). No other significant associations emerged between baseline features in FE and progression to exudative AMD.

Conclusions : Type 3 MNV in the exudative AMD eye and presence of iHRF, SDD and Cuticular drusen in FEs of patients with exudative AMD may identify eyes at high risk of progression to MNV throughout a 10-year period. Further studies with larger sample sizes will be needed to confirm these findings.

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