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Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
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OCT-Defined Atrophic Age-Related Macular Degeneration Changes Associated with Deep Visual Sensitivity Losses: A
Zhichao Wu1,2, Barbara A Blodi3, Frank G Holz4
1Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Ophthalmology Science
|September 2, 2025
Summary
This study identified specific optical coherence tomography (OCT) features that define atrophic age-related macular degeneration (AMD) lesions associated with significant vision loss. These OCT criteria can help identify nonresponding areas in clinical trials for AMD treatments.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- Atrophic AMD involves degeneration of the retinal pigment epithelium and photoreceptors.
- Accurate identification of atrophic lesions is crucial for clinical trials.
Purpose of the Study:
- To determine combinations of optical coherence tomography (OCT) findings that characterize atrophic AMD lesions.
- To correlate these OCT features with repeatable deep visual sensitivity defects.
Main Methods:
- 171 OCT scans from 60 eyes of 53 participants with incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) were analyzed.
- 12 readers annotated OCT B-scans for 7 features of RPE and outer retinal atrophy.
- High-density targeted microperimetry was performed to assess visual sensitivity defects.
Main Results:
- Complete RPE and outer retinal atrophy (cRORA) lesions (≥250 μm width) showed a 60% prevalence of significant vision defects.
- Lesions with hypertransmission and complete RPE loss (≥500 μm) demonstrated 92-98% prevalence of defects.
- Specific OCT criteria, including hypertransmission and RPE abnormalities, correlated strongly with nonresponding areas.
Conclusions:
- Established OCT criteria can define atrophic AMD lesions with functional characteristics of nonresponding areas (≥90% prevalence of repeatable ≤10 dB defect).
- These OCT-defined lesions can serve as clinically relevant endpoints for evaluating preventative treatments in end-stage atrophic AMD.
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