Abstract
Purpose :
To assess the association between presence of optical coherence tomography (OCT) biomarkers associated with a higher risk for progression to complete retinal pigment epithelium and outer retinal atrophy (cRORA) in age-related macular degeneration (AMD) in the same location as cRORA.
Methods :
Patients with dry AMD who had evidence of cRORA and OCT data available for 48 ± 4 months prior to the first visit with evidence of cRORA were included in this retrospective case-control analysis. At the baseline visit, (48 months before the development of cRORA), OCT B-scans at the location of the future cRORA (case region) were evaluated for the presence of large drusen, drusenoid pigment epithelial detachments (PED), drusen with hyporeflective cores (hcD) subretinal drusenoid deposits (SDD), cuticular drusen, thick and thin double-layer signs (DLS), intraretinal hyperreflective foci (IHRF), and acquired vitelliform lesions (AVL). Regions within the same eye at the same distance from the fovea as the region which progressed to cRORA, but which did not progress to cRORA were selected as the control regions. The frequency of the OCT features in the case regions were compared to the control regions using chi-square test and associations were assessed by univariate and multivariate logistic regression analysis.
Results :
A total of 57 AMD eyes (of 41 patients) with cRORA were included. Mean follow-up time was 44.69 ± 6.56 months. The presence of hcD, cuticular drusen, SDD, or thick DLS at baseline were not associated with an increased risk for development of cRORA at that location 4 years later (Table). Presence of large drusen, drusenoid PED, AVL, thin DLS, and IHRF were all associated with a significantly increased risk of cRORA at that location (Table). Multivariable logistic regression revealed that IHRF (P-value: <0.001, OR= 8.559), drusenoid PED (P-value: 0.001, OR= 7.148), and a thin DLS (P-value: 0.021, OR= 3.483) were independent predictors of development of cRORA at that location.
Conclusions :
The presence of IHRF, drusenoid PED, and thin DLS are independent predictors of the development of cRORA at that same location. These findings would support the inclusion of these features within a more granular staging system defining specific steps in the progression from early dry AMD to atrophy.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.