Abstract
Purpose :
To describe and evaluate donut-shaped hypertransmission defects on en face sub-RPE optical coherence tomography (OCT) imaging and the associated findings seen on OCT B-scans in eyes with intermediate and advanced age-related macular degeneration (AMD) using a retrospective, observational study.
Methods :
This study included 21 eyes with intermediate or advanced AMD imaged at the New England Eye Center. A donut-shaped hypertransmission defect was defined as a hypertransmission defect surrounding a central area of hypotransmission on en face OCT. Donut-shaped hypertransmission defects on custom en face sub-RPE slabs and their associated B-scans were acquired using a 3 µm, 128 kHz A-scan rate ultrahigh resolution spectral-domain OCT (UHR SD-OCT) and/or commercial SD-OCT devices.
Results :
A total of 40 donut-shaped hypertransmission defects from 21 patients were identified on en face OCT. The donut-shaped hypertransmission defects were found to be associated with RPE migration, drusen with heterogenous or non-reflective homogenous contents, incomplete retinal pigment epithelium and outer retinal atrophy (iRORA), and/or complete retinal pigment epithelium and outer retinal atrophy (cRORA) on associated commercial and UHR SD-OCT B-scans. In each case, the hypertransmission on en face OCT corresponded to choroidal hypertransmission secondary to RPE disruption on associated B-scans. In 9 lesions, a clump of preserved RPE in the center of iRORA or cRORA lesions was observed with associated relative hypotransmission into the choroid, as seen in Figure 1; this area of preserved RPE corresponded to the central area of hypotransmission on en face OCT.
Conclusions :
Donut-shaped hypertransmission defects on en face OCT sub-RPE slabs were evaluated and found to be associated with various findings on SD-OCT B-scans, including RPE migration, drusen with homogenous or heterogenous contents, iRORA, and/or cRORA. Future longitudinal studies may be performed to determine if the presence of donut-shaped lesions is associated with faster progression to advanced AMD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.