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Optical coherence tomography predictors of progression of non-exudative age-related macular degeneration to advanced atrophic and exudative disease

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To study the natural history of optical coherence tomography (OCT) imaging-based findings seen in non-exudative age-related macular degeneration (neAMD) and model their relative likelihood in predicting development of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA), complete retinal pigment epithelium and outer retinal atrophy (cRORA), and neovascular AMD (nAMD).

Methods

Retrospective chart review was performed at two academic practices. Patients diagnosed with neAMD for whom yearly OCT scans were obtained for at least 4 consecutive years were included. Baseline demographic, visual acuity, AREDS staging, and OCT data were collected. OCTs were assessed for the presence or absence of eleven features previously individually associated with progression of neAMD, both at baseline, and on all subsequent follow-up scans. Likewise, charts were reviewed to assess visual acuity and staging of NEAMD at all follow-up visits. A multivariate regression analysis was constructed to determine predictors of iRORA, cRORA, and nAMD.

Results

A total of 107 eyes of 88 patients were evaluated. Follow-up included yearly OCTs obtained over at least 4 consecutive years follow-up (range: 50–94 months). During the follow-up period, 17 eyes progressed to iRORA while 25 progressed to cRORA and 16 underwent conversion to nAMD. Predictors of conversion to iRORA and cRORA included integrity of the external limiting membrane (p = 0.02), the ellipsoid zone (p = 0.01), and the cone outer segment line (p = 0.003) and the presence of intraretinal hyporeflective spaces (p = 0.009), drusen ooze (p = 0.05), and drusen collapse (p = 0.001). OCT features predictive of conversion to nAMD included outer nuclear layer (ONL) loss (p = 0.01), presence of intraretinal (p = 0.001) and subretinal (p = 0.005) hyporeflective spaces, and drusen collapse (p = 0.003).

Conclusion

Of these multiple factors predictive of progression of neAMD, the OCT feature most strongly correlated to progression to iRORA/cRORA was drusen collapse, and the feature most predictive of conversion to nAMD was the presence of intraretinal hyporeflective spaces.

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Acknowledgements

Age Related Macular Degeneration Study Group: Amarasekera, Sohani1; Singh, Sumit R2; Samanta, Anindya3; Jhingan, Mahima2; Arora, Supriya4; Tucci, Davide5; Martel, Joseph N1; Friberg, Thomas R1; Gallagher, Denise1; Errera, Marie Helene1; Eller, Andrew W1; Cagini, Carlo5; Sahel, Jose A1; Lupidi, Marco5; Chhablani, Jay1

Affiliations:

1. University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

2. Joan and Irwin Jacobs Retina Center, La Jolla, CA, United States.

3. Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, United States.

4. Princess Margaret Hospital, Bahamas.

5. Universita degli Studi di Perugia Facolta di Medicina e Chirurgia, Perugia, Umbria, Italy.

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Authors and Affiliations

  1. University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA, 15213, USA

    Sohani Amarasekera & Jay Chhablani

  2. Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA

    Anindya Samanta

  3. Joan and Irwin Jacobs Retina Center, La Jolla, CA, USA

    Mahima Jhingan & Sumit Singh

  4. Princess Margaret Hospital, Nassau, Bahamas

    Supriya Arora

  5. Universita Degli Studi Di Perugia Facolta Di Medicina E Chirurgia, Perugia, Umbria, Italy

    Davide Tucci & Marco Lupidi

Authors
  1. Sohani Amarasekera
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  2. Anindya Samanta
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  3. Mahima Jhingan
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  4. Supriya Arora
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  5. Sumit Singh
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  6. Davide Tucci
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  7. Marco Lupidi
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  8. Jay Chhablani
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on behalf of the Age Related Macular Degeneration study group

Corresponding author

Correspondence to Jay Chhablani.

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Ethical approval was waived by the local Ethics Committee of University Pittsburgh in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.

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Informed consent was obtained from all individual participants included in the study.

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Informed consent was obtained from all individual participants included in the study.

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Amarasekera, S., Samanta, A., Jhingan, M. et al. Optical coherence tomography predictors of progression of non-exudative age-related macular degeneration to advanced atrophic and exudative disease. Graefes Arch Clin Exp Ophthalmol 260, 737–746 (2022). https://doi.org/10.1007/s00417-021-05419-2

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  • DOI: https://doi.org/10.1007/s00417-021-05419-2

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