June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Incomplete RPE and Outer Retinal Atrophy (iRORA) Development in Dry Age-Related Macular Degeneration (AMD) in Patients with Fellow-Eye Neovascular AMD
Author Affiliations & Notes
  • Hanna Choi
    New England Retina Consultants, Springfield, Massachusetts, United States
  • Giulia Corradetti
    Doheny Eye Institute, Pasadena, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Sophiana Lindenberg
    Doheny Eye Institute, Pasadena, California, United States
  • Ayesha Nuri Karamat
    Doheny Eye Institute, Pasadena, California, United States
  • Deniz Oncel
    Doheny Eye Institute, Pasadena, California, United States
  • Henry Liu
    Doheny Eye Institute, Pasadena, California, United States
  • Ramya Gnanaraj
    Doheny Eye Institute, Pasadena, California, United States
  • Sohaib Fasih-Ahmad
    Doheny Eye Institute, Pasadena, California, United States
  • Kenneth Marion
    Doheny Eye Institute, Pasadena, California, United States
  • Kirstie Baker
    Doheny Eye Institute, Pasadena, California, United States
  • Shilpa Gulati
    New England Retina Consultants, Springfield, Massachusetts, United States
  • Bradley Foster
    New England Retina Consultants, Springfield, Massachusetts, United States
  • Andrew Lam
    New England Retina Consultants, Springfield, Massachusetts, United States
  • SriniVas R Sadda
    Doheny Eye Institute, Pasadena, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • David Lally
    New England Retina Consultants, Springfield, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Hanna Choi None; Giulia Corradetti None; Sophiana Lindenberg None; Ayesha Karamat None; Deniz Oncel None; Henry Liu None; Ramya Gnanaraj None; Sohaib Fasih-Ahmad None; Kenneth Marion None; Kirstie Baker None; Shilpa Gulati None; Bradley Foster None; Andrew Lam None; SriniVas Sadda None; David Lally None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 920. doi:
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      Hanna Choi, Giulia Corradetti, Sophiana Lindenberg, Ayesha Nuri Karamat, Deniz Oncel, Henry Liu, Ramya Gnanaraj, Sohaib Fasih-Ahmad, Kenneth Marion, Kirstie Baker, Shilpa Gulati, Bradley Foster, Andrew Lam, SriniVas R Sadda, David Lally; Incomplete RPE and Outer Retinal Atrophy (iRORA) Development in Dry Age-Related Macular Degeneration (AMD) in Patients with Fellow-Eye Neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2023;64(8):920.

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

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Abstract

Purpose : To determine the risk for developing incomplete retinal pigment epithelium (RPE) and Outer Retinal Atrophy (iRORA) in dry age-related macular degeneration (AMD) in patients with fellow-eye neovascular AMD.

Methods : This was a retrospective, longitudinal study of patients with baseline neovascular AMD in one eye and dry AMD without iRORA or complete RPE and Outer Retinal Atrophy (cRORA) in the fellow eye. Optical Coherence Tomography 512x128 macular cubes (Cirrus HD-OCT, Zeiss, Dublin, CA) were evaluated in the dry AMD eye by trained graders for the presence of iRORA at 2 years. The presence of intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), subretinal drusenoid deposits (SDD), and drusen volume (mm3) at baseline were recorded. iRORA risk conferred by each biomarker was evaluated using Cox regression (p<0.05; Confidence interval (CI) 95%). Results were visualized using a Kaplan-Meier survival curve.

Results : 106 patients (106 eyes) met inclusion criteria with a median age of 80 years (IQR = 73 to 86, range = 57 to 94); 69 (65%) were female. Kaplan Meier survival analysis showed 32.08% (n=34) developed iRORA by 24 months (interquartile range (IQR) 23 to 24, range = 22 to 26) (Figure 1) while one eye (0.9%) developed cRORA. iRORA appeared at a median (IQR) interval of 4 (3 to 4.75) months. Baseline IHRF alone conferred increased risk for development of iRORA (HR [95% CI] = 2.046 [1.01; 3.93]; p=0.039) (Table 1).

Conclusions : In patients with fellow-eye neovascular AMD, the dry AMD eye had a 32% risk of iRORA development by 2 years. Baseline IHRF was associated with a 2-fold increased risk of iRORA development by 2 years. Further studies on the time to iRORA development are needed to explore the development of iRORA as a potential endpoint for future dry AMD clinical trials.

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

 

Figure 1. Development of iRORA in 106 eyes with early to intermediate AMD by 24 months.

Figure 1. Development of iRORA in 106 eyes with early to intermediate AMD by 24 months.

 

Table 1. Cox Regression of OCT biomarkers, age, and sex on the risk of iRORA development by 24 months.

Table 1. Cox Regression of OCT biomarkers, age, and sex on the risk of iRORA development by 24 months.

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