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Inner Retinal Reflectivity Loss and Concurrent Thickening Predict Short-Term Conversion to Neovascular AMD
Matt Trinh1, Enrico Borrelli2,3, Michele Reibaldi2,3
1School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
Investigative Ophthalmology & Visual Science
|February 17, 2026
Summary
Inner retinal reflectivity loss and thickening predict progression from intermediate age-related macular degeneration (iAMD) to neovascular AMD (nAMD). These optical coherence tomography (OCT) biomarkers offer improved short-term risk assessment over traditional factors.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Intermediate age-related macular degeneration (iAMD) can progress to exudative neovascular AMD (nAMD).
- Identifying early biomarkers for nAMD conversion is crucial for timely intervention.
- Current risk factors for iAMD progression are limited in predictive accuracy.
Purpose of the Study:
- To investigate inner retinal changes preceding iAMD to nAMD conversion.
- To analyze topographic optical coherence tomography (OCT) reflectivity and thickness variations.
- To assess the predictive value of OCT-derived biomarkers for nAMD development.
Main Methods:
- Retrospective case-control study of 60 eyes (30 converters, 30 non-converters).
- Macular OCT scans analyzed for retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) reflectivity and thickness.
- Comparison of baseline OCT metrics between converters and non-converters, adjusted for confounding factors.
Main Results:
- Converters exhibited global RNFL, GCL, and IPL reflectivity reduction and RNFL thickening.
- Topographic analysis revealed nasal reflectivity loss and localized thickening in nasal RNFL and paracentral GCL/IPL.
- Inner retinal reflectivity loss and RNFL thickening were significant predictors of nAMD conversion, outperforming traditional risk factors.
Conclusions:
- Inner retinal reflectivity loss with mild thickening predicts short-term progression to nAMD.
- OCT-derived biomarkers demonstrate superior predictive power for nAMD conversion compared to traditional factors.
- These biomarkers may enhance short-term risk stratification and monitoring of iAMD patients.
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