Abstract
Purpose :
To evaluate novel, automated biomarkers, pigment epithelial detachment composition indices (PEDCI), in the quantification of anti-vascular endothelial growth factor (anti-VEGF) treatment related effects and assessment of disease activity in neovascular age-related macular degeneration (nAMD).
Methods :
A retrospective analysis of 37 eyes from 34 patients with nAMD receiving anti-VEGF treatment was performed. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) images were acquired at a treatment-naïve baseline and 3-, 6-, 12-, 18-, and 24- month follow-up visits. Only patients with pigment epithelial detachments (PED) visualized on OCT at baseline were included in the study. Traditional imaging biomarkers such as central macular thickness (CMT), subfoveal choroidal thickness (SFCT), intraretinal fluid (IRF) area, and subretinal fluid (SRF) area were calculated directly from OCT images. An automated image processing technique was used to classify PED components and calculate novel imaging biomarkers, PEDCI-S, PEDCI-N, and PEDCI-F, which quantify relative areas of serous, neovascular, and fibrous tissue respectively.
Results :
Mean (± SD) BCVA (in logMAR) was 0.60±0.47, 0.45±0.41, 0.49±0.49, 0.61±0.54, 0.59±0.56, and 0.67±0.57 at baseline, 3, 6, 12, 18, and 24 months respectively. Overall, BCVA showed minimal worsening of visual acuity with an increase of 0.07±0.54 logMAR which was not statistically significant (p = 0.07). Through 24 months, ANOVA analysis of mean PEDCI-F and PEDCI-S showed an overall reduction of 0.004 (p = 0.03) and 0.095 (p = 0.16) respectively. PEDCI-N showed an overall increase of 0.099 (p = 0.06). PEDCI-F showed a weak, negative correlation with BCVA.
Conclusions :
Longitudinal analysis of PEDCI supports their utility as biomarkers that characterize treatment related effects by quantifying the relative composition of PEDs. Correlation of PEDCI with visual acuity is comparable to other imaging biomarkers.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.