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Updated: Jan 25, 2026
Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
OCT Risk Factors for Progression to Late-Stage Age-Related Macular Degeneration in the Amish Eye Study
Yu-Chien Chung1, Mai Alhelaly2, Muneeswar G Nittala3
1Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, David Geffen School of Medicine of the University of California-Los Angeles, Los Angeles, California; Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
Purpose:
To characterize the prevalence of some critical OCT biomarkers-including cuticular drusen and acquired vitelliform lesions (AVLs)-and to identify their relative risk for progression to late age-related macular degeneration (AMD) over 2 years in subjects with early or intermediate AMD in the Amish Eye Study.
Design:
Prospective, observational, longitudinal, population-based cohort study.
Participants:
This study included 276 eyes from 171 subjects with early or intermediate AMD at baseline who completed the 2-year follow-up.
Methods:
Baseline OCT scans were evaluated for the presence of cuticular drusen, AVLs, subretinal drusenoid deposits (SDDs), high drusen volume (defined as ≥0.2 mm3 within the central 5 mm), intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDCs), thick/thin double-layer sign (DLS), and incomplete retinal pigment epithelium and outer retinal atrophy (iRORA). Subfoveal choroidal thickness (SFCT) was also measured.
Main Outcome Measures:
Incidence of late AMD (geographic atrophy or macular neovascularization) at 2 years as determined by multimodal imaging (OCT, color fundus photography, and confocal fundus autofluorescence).
Results:
By 2 years of follow-up, 26 eyes (10.7%) progressed to late AMD. The most prevalent baseline features in this cohort, in descending order, were cuticular drusen (52.3%), IHRF (17.3%), hDC (16.0%), thin DLS (11.9%), SDD (8.2%), iRORA (7.8%), AVL (7.0%), and high drusen volume (2.5%). The mean SFCT was 243.23 ± 75.45 μm. Univariate analysis demonstrated that the presence of thick DLS, iRORA, AVL, SDD, IHRF, hDC, and SFCT was associated with an increased risk of progression. In multivariate regression, only the presence of iRORA (odds ratio [OR], 29.60; 95% confidence interval [CI], 6.86-127.84; P < 0.001) and AVL (OR, 15.90; 95% CI, 3.24-78.00; P < 0.001) remained significant, whereas the presence of IHRF showed borderline significance (OR, 4.71; 95% CI, 1.00-22.16; P = 0.050).
Conclusions:
In this cohort, the presence of iRORA and AVL was independently associated with progression to late AMD over 2 years. Although cuticular drusen were highly prevalent, their presence, as assessed in this study, was not significantly associated with an increased risk of progression to late AMD.
Financial Disclosure(S):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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