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Matt Trinh, Michael Kalloniatis, David Alonso-Caneiro, Lisa Nivison-Smith; Topographical Differences Vary Significantly Across All Retinal Layers in the Early Stages of Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2022;63(7):361 – F0192.
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© ARVO (1962-2015); The Authors (2016-present)
Early changes in age-related macular degeneration (AMD) are suggested to extend beyond the outer retina, although locations of these changes are unclear. This study examines anatomical topographical differences across all retinal layers in early/intermediate AMD using high-density OCT analysis.
OCT macular cube scans of 96 early/intermediate AMD and 96 normal eyes from individual participants propensity-score matched on age, sex, and refraction were retrospectively recruited. High-density (60×60 0.01mm2) grid thicknesses were custom-extracted and compared between AMD and normal eyes corrected for confounding. ‘Normal-differences’ were formed and underwent cluster analysis to reveal topography for the retinal nerve fibre (RNFL), ganglion cell (GCL), inner plexiform (IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear+Henle’s fibre (ONL+HFL) layers, inner- and outer-segments (IS/OS), and retinal pigment epithelium-to-Bruch’s membrane (RPE-BM).
AMD macular clusters across the inner retina (Fig 1) displayed extensively thinned RNFL, GCL, IPL, and paracentral INL (mean±SD, up to −8.44±1.51µm, P=0.63 to <0.0001) and thickened INL elsewhere. The outer retina (Fig 2) exhibited thinned OPL/ONL+HFL paracentrally, IS/OS centrally, RPE-BM peripherally (up to −2.14±0.48µm, P=0.18 to <0.001), and thickened RPE-BM centrally (up to +5±1.14µm, P<0.01). Effect sizes (−2.74−+18.37SD), cluster sizes (2.2−60.1% area), and eccentricity effects varied.
Anatomical topographical differences are evident across all retinal layers in early/intermediate AMD. These results help define where changes may lie in the early stages of AMD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Inner retinal cluster analysis. Normal-differences (µm) of each cluster presented for the RNFL, GCL, IPL, and INL as graphs (A, C, E, G) and topography maps (B, D, F, H), respectively. SD units below x-axis. Significance: * P < 0.05, ** P < 0.01, *** P < 0.001, **** P < 0.0001. Clusters separated into ranks based on magnitude of normal-difference and represented via colour scale: C−1, −2, −3… = more thinned = darker blue; C+1, +2, +3… = more thickened = darker green; C0 = cluster mean ± SD crossing zero = cream. All images in right eye format.
Outer retinal cluster analysis presented for the OPL/ONL+HFL, IS/OS, and RPE-BM as graphs (A, C, E) and topography maps (B, D, F), respectively. Presentation as in Fig 1.
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