Functional Outcomes Across High-Risk OCT-Based Phenotypes in Intermediate Age-Related Macular Degeneration-PINNACLE...

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Intermediate age-related macular disease (iAMD) is a significant cause of vision impairment.
• Optical coherence tomography (OCT) provides detailed structural imaging of the retina.
• Understanding the link between OCT biomarkers and visual function in iAMD is crucial for management.

Purpose of the Study:

• To assess the association between OCT biomarkers and visual function in iAMD.
• To determine if OCT-based stratification identifies iAMD phenotypes with poor visual function.

Main Methods:

• Analysis of OCT imaging, microperimetry, and visual acuity tests from the PINNACLE trial cohort.
• Quantification of drusen volume, outer nuclear layer (ONL), and ellipsoid zone (EZ) thickness.
• Linear mixed-effect models to evaluate associations and stratify eyes into phenotypes.

Main Results:

• Subretinal drusenoid deposits (SDDs) and retinal atrophy markers correlated with reduced retinal sensitivity.
• Increased drusen volume and decreased ONL/EZ thickness were linked to lower sensitivity.
• Hyperreflective foci (HRF) and drusen volume changes affected best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), and low-luminance deficits (LLDs).
• Distinct iAMD phenotypes showed significant functional differences, particularly those with early atrophy.

Conclusions:

• Integrating OCT biomarkers and functional assessments reveals iAMD phenotypes associated with significant visual deficits.
• Early atrophy markers identified via OCT are important for patient selection and risk stratification in clinical trials and practice.