June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Baseline optical coherence tomography biomarkers predictive of progression to late age-related macular degeneration
Author Affiliations & Notes
  • Antonio Yaghy
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Hiroyuki Takahashi
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Naira Raquel dos Santos Xilau
    Tufts University School of Medicine, Boston, Massachusetts, United States
  • Jonathan Caranfa
    New England Eye Center, Boston, Massachusetts, United States
  • Alex C Camacho
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Luísa S.M. Mendonca
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Alexander Hüther
    Tufts University School of Medicine, Boston, Massachusetts, United States
  • Emily Levine
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Eugenia Custo Greig
    OCT Lab, New England Eye Center, Boston, Massachusetts, United States
  • Caroline R Baumal
    New England Eye Center, Boston, Massachusetts, United States
  • Michelle C Liang
    New England Eye Center, Boston, Massachusetts, United States
  • Elias Reichel
    New England Eye Center, Boston, Massachusetts, United States
  • Andre J Witkin
    New England Eye Center, Boston, Massachusetts, United States
  • Jay S Duker
    New England Eye Center, Boston, Massachusetts, United States
  • Nadia K Waheed
    New England Eye Center, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Antonio Yaghy Boston Image Reading Center, Stealth Biotherapeutics, Code C (Consultant/Contractor); Hiroyuki Takahashi None; Naira Raquel dos Santos Xilau None; Jonathan Caranfa None; Alex Camacho None; Luísa Mendonca Gyroscope therapeutics, Code C (Consultant/Contractor), Boston Image Reading Center, Code E (Employment); Alexander Hüther None; Emily Levine None; Eugenia Custo Greig None; Caroline Baumal Genentech, Regeneron, Roche, Apellis, Eyepoint, Code C (Consultant/Contractor); Michelle Liang None; Elias Reichel None; Andre Witkin None; Jay Duker Auro Biosciences, Code C (Consultant/Contractor), EyePoint Pharmaceuticals, Code E (Employment), Sesen Bio, Hubble Therapeutics, Code S (non-remunerative); Nadia Waheed Topcon, Complement Therapeutics, Olix Pharma, Iolyx Pharmaceuticals, Hubble, Saliogen, Syncona, Code C (Consultant/Contractor), AGTC, Code E (Employment), Zeiss, Topcon, Nidek, Code F (Financial Support), Ocudyne, Gyroscope, Code I (Personal Financial Interest), Nidek, Code R (Recipient)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2151. doi:
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      Antonio Yaghy, Hiroyuki Takahashi, Naira Raquel dos Santos Xilau, Jonathan Caranfa, Alex C Camacho, Luísa S.M. Mendonca, Alexander Hüther, Emily Levine, Eugenia Custo Greig, Caroline R Baumal, Michelle C Liang, Elias Reichel, Andre J Witkin, Jay S Duker, Nadia K Waheed; Baseline optical coherence tomography biomarkers predictive of progression to late age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2151.

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

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Abstract

Purpose : Intermediate age-related macular degeneration (AMD) can progress to vision-threatening advanced forms of AMD: macular neovascularization (MNV) and geographic atrophy (GA). Optical coherence tomography (OCT) allows for the detection of qualitative and quantitative biomarkers that can be followed over time, providing insights into the risk of disease progression. We aim to determine the risk that specific OCT biomarkers carry for the progression of intermediate to advanced AMD.

Methods : We evaluated 751 patients at the New England Eye Center with intermediate AMD and 18 months follow-up. Patients with complete retinal pigment epithelium (RPE) and outer retinal atrophy, retinal fluid, macular pucker, or full thickness macular hole at baseline were excluded. The outcome (no progression, progression to MNV, progression to GA) at date last seen was determined by a certified retina specialist based on 512x128 volumetric OCT B-scans, and confirmed by a second masked grader. Baseline volumetric OCT B-scans were then retrieved and analyzed by two masked graders for the presence/absence of 24 OCT biomarkers.

Results : 501 (67%) of the 751 patients did not progress to advanced AMD, 130 (17%) progressed to MNV, and 120 (16%) progressed to GA. Risk factors for progression to GA include calcified drusen (HR=2.9, p=0.02), cuticular drusen (HR=4.2, p<0.001), area of hypertransmission into the choroid (HR=3.1, p<0.001), and subsidence of inner nuclear and outer plexiform layers (HR=4.1, p=0.005). Risk factors for progression to MNV include external limiting membrane disruption (HR=5.7, p=0.02), ellipsoid zone disintegrity (HR=5.1, p=0.007), and subretinal hyperreflective material (HR=2.2, p=0.03). Common risk factors for progression to GA and MNV include drusenoid pigment epithelial detachment (HR=2.1, p=0.002 and HR=1.9, p=0.002), hyporeflective core within drusen (HR=1.8, p=0.03 and HR=2.3, p=0.002), double-layer sign (HR=7.7, p<0.001 and HR=3.4, p=0.04), intraretinal hyperreflective foci (HR=2.4, p<0.001 and HR=2.7, p<0.001), and RPE attenuation/disruption (HR=3.6, p<0.001 and HR=2.1, p=0.002), respectively.

Conclusions : The rate of progression from intermediate AMD to MNV and GA was 17% and 16% at an average of 37 and 41 months, respectively with specific baseline OCT biomarkers demonstrating the ability to predict risk of progression from intermediate to advanced forms of disease.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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