Abstract
Purpose :
The symmetry of macular fundus features in the two eyes of the same patient with age-related macular degeneration (AMD) was investigated using swept-source optical coherence tomography (SS-OCT).
Methods :
AMD patients were enrolled in a prospective SS-OCT natural history study from April 2016 to June 2021. SS-OCT imaging was performed at the time of their first visit. Two graders diagnosed the presence of drusen, geographic atrophy (GA), and exudative AMD (eAMD) in each eye. Medical records were reviewed to assess prior exudation. Validated algorithms were used to measure the area and volume of drusen. To assess asymmetry, one eye of each patient was randomly selected as the index eye and compared with the fellow eye. The kappa statistic (κ) was used to assess the symmetry of diagnosis. The intraclass correlation coefficient (ICC) was used to assess the symmetry of the drusen area and volume.
Results :
A total of 1310 patients with AMD were included. The average age was 78 years old (range, 50-102) with 60% women. Of the 1310 subjects, 54% (701) presented with symmetric disease; 20% with bilateral drusen, 11% with bilateral GA, and 22% with bilateral eAMD. Only 0.5% of subjects had both GA and eAMD in both eyes. Of the randomly selected index eyes, 825 (47%) were right eyes. Overall, limited interocular agreement was observed between index and fellow eyes (54%; κ = 0.29). Kappa coefficients were poor (<0.4) for index eyes diagnosed with drusen (κ = 0.27), eAMD (κ = 0.17), and mixed disease (κ = 0.03). There was moderate agreement between index and fellow eyes for GA (κ = 0.50). Of the 265 patients with bilateral drusen, the symmetry of drusen area measurements had moderate ICC values of 0.70, 0.71 and 0.70 in the 3 mm and 5 mm diameter circles centered on the fovea and in the total scan area, respectively. The ICC for the drusen volume was slightly lower with ICC values of 0.65, 0.66 and 0.64 respectively.
Conclusions :
Interocular symmetry was poor for eyes with drusen, eAMD, and mixed, but moderate for GA. While the diagnosis of drusen was not appreciably symmetric between eyes, the drusen area and volume measurements were moderately symmetric in patients with bilateral drusen.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.