OCT Risk Factors for Development of Atrophy in Eyes with Intermediate Age-Related Macular Degeneration

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Intermediate age-related macular degeneration (iAMD) is a precursor to advanced forms of AMD.
• Identifying biomarkers for iAMD progression is crucial for patient management and clinical trial design.
• Optical Coherence Tomography (OCT) is a key imaging modality for assessing AMD biomarkers.

Purpose of the Study:

• To determine the frequency of various OCT biomarkers in patients with iAMD.
• To investigate the relationship between these OCT biomarkers and the development of complete retinal pigment epithelium and outer retinal atrophy (cRORA) over a 2-year period.

Main Methods:

• Retrospective cohort study including 330 eyes of 330 patients with iAMD.
• Spectralis OCT volume scans were analyzed at baseline for biomarkers: high-central drusen volume (DV), intraretinal hyper-reflective foci (IHRF), subretinal drusenoid deposits (SDDs), hypo-reflective drusen cores (hDCs), and double-layer sign (DLS).
• Fellow eye AMD status was also assessed, including presence of cRORA.

Main Results:

• Over 24 months, 16.36% of iAMD eyes progressed to cRORA.
• Baseline biomarkers significantly associated with increased cRORA risk included high-central DV, IHRF, SDD, hDC, thin DLS, and cRORA in the fellow eye.
• Odds ratios indicated substantial risk increases for these biomarkers, with P values < 0.05.

Conclusions:

• In addition to previously known factors (DV, IHRF, hDC, SDD), a thin DLS and fellow eye cRORA are associated with higher risk of progression to cRORA.
• These OCT biomarkers can assist in prognostication and risk stratification for iAMD.
• Identification of these biomarkers may improve patient selection for clinical trials targeting AMD progression.