Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration

Jessica N. Leuschen, Stefanie G. Schuman, Katrina P. Winter, Michelle N. McCall, Wai T. Wong, Emily Y. Chew, Thomas Hwang, Sunil Srivastava, Neeru Sarin, Traci Clemons, Molly Harrington, Cynthia A. Toth

Research output: Contribution to journalArticle

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Abstract

Purpose: Describe qualitative spectral-domain optical coherence tomography (SD-OCT) characteristics of eyes classified as intermediate age-related macular degeneration (nonadvanced AMD) from Age-Related Eye Disease Study 2 (AREDS2) color fundus photography (CFP) grading. Design: Prospective cross-sectional study. Participants: We included 345 AREDS2 participants from 4 study centers and 122 control participants who lack CFP features of intermediate AMD. Methods: Both eyes were imaged with SD-OCT and CFP. The SD-OCT macular volume scans were graded for the presence of 5 retinal, 5 subretinal, and 4 drusen characteristics. In all, 314 AREDS2 participants with ≥1 category-3 AMD eye and all controls each had 1 eye entered into SD-OCT analysis, with 63 eyes regraded to test reproducibility. Main Outcome Measures: We assessed SD-OCT characteristics at baseline. Results: In 98% of AMD eyes, SD-OCT grading of all characteristics was successful, detecting drusen in 99.7%, retinal pigment epithelium (RPE) atrophy/absence in 22.9%, subfoveal geographic atrophy in 2.5%, and fluid in or under the retina in 25.5%. Twenty-eight percent of AMD eyes had characteristics of possible advanced AMD on SD-OCT. Two percent of control eyes had drusen on SD-OCT. Vision loss was not correlated with foveal drusen alone, but with foveal drusen that were associated with other foveal pathology and with overlying focal hyperreflectivity. Focal hyperreflectivity over drusen, drusen cores, and hyper- or hyporeflectivity of drusen were also associated with RPE atrophy. Conclusions: Macular pathologies in AMD can be qualitatively and reproducibly evaluated with SD-OCT, identifying pathologic features that are associated with vision loss, RPE atrophy, and even possibly the presence of advanced AMD not apparent on CFP. Qualitative and detailed SD-OCT analysis can contribute to the anatomic characterization of AMD in clinical studies of vision loss and disease progression. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Original languageEnglish (US)
Pages (from-to)140-150
Number of pages11
JournalOphthalmology
Volume120
Issue number1
DOIs
StatePublished - Jan 2013

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Optical Coherence Tomography
Macular Degeneration
Photography
Eye Diseases
Retinal Pigment Epithelium
Color
Atrophy
Disclosure
Geographic Atrophy
Pathology
Disease Progression
Retina
Cross-Sectional Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Leuschen, J. N., Schuman, S. G., Winter, K. P., McCall, M. N., Wong, W. T., Chew, E. Y., ... Toth, C. A. (2013). Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration. Ophthalmology, 120(1), 140-150. https://doi.org/10.1016/j.ophtha.2012.07.004

Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration. / Leuschen, Jessica N.; Schuman, Stefanie G.; Winter, Katrina P.; McCall, Michelle N.; Wong, Wai T.; Chew, Emily Y.; Hwang, Thomas; Srivastava, Sunil; Sarin, Neeru; Clemons, Traci; Harrington, Molly; Toth, Cynthia A.

In: Ophthalmology, Vol. 120, No. 1, 01.2013, p. 140-150.

Research output: Contribution to journalArticle

Leuschen, JN, Schuman, SG, Winter, KP, McCall, MN, Wong, WT, Chew, EY, Hwang, T, Srivastava, S, Sarin, N, Clemons, T, Harrington, M & Toth, CA 2013, 'Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration', Ophthalmology, vol. 120, no. 1, pp. 140-150. https://doi.org/10.1016/j.ophtha.2012.07.004
Leuschen, Jessica N. ; Schuman, Stefanie G. ; Winter, Katrina P. ; McCall, Michelle N. ; Wong, Wai T. ; Chew, Emily Y. ; Hwang, Thomas ; Srivastava, Sunil ; Sarin, Neeru ; Clemons, Traci ; Harrington, Molly ; Toth, Cynthia A. / Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration. In: Ophthalmology. 2013 ; Vol. 120, No. 1. pp. 140-150.
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abstract = "Purpose: Describe qualitative spectral-domain optical coherence tomography (SD-OCT) characteristics of eyes classified as intermediate age-related macular degeneration (nonadvanced AMD) from Age-Related Eye Disease Study 2 (AREDS2) color fundus photography (CFP) grading. Design: Prospective cross-sectional study. Participants: We included 345 AREDS2 participants from 4 study centers and 122 control participants who lack CFP features of intermediate AMD. Methods: Both eyes were imaged with SD-OCT and CFP. The SD-OCT macular volume scans were graded for the presence of 5 retinal, 5 subretinal, and 4 drusen characteristics. In all, 314 AREDS2 participants with ≥1 category-3 AMD eye and all controls each had 1 eye entered into SD-OCT analysis, with 63 eyes regraded to test reproducibility. Main Outcome Measures: We assessed SD-OCT characteristics at baseline. Results: In 98{\%} of AMD eyes, SD-OCT grading of all characteristics was successful, detecting drusen in 99.7{\%}, retinal pigment epithelium (RPE) atrophy/absence in 22.9{\%}, subfoveal geographic atrophy in 2.5{\%}, and fluid in or under the retina in 25.5{\%}. Twenty-eight percent of AMD eyes had characteristics of possible advanced AMD on SD-OCT. Two percent of control eyes had drusen on SD-OCT. Vision loss was not correlated with foveal drusen alone, but with foveal drusen that were associated with other foveal pathology and with overlying focal hyperreflectivity. Focal hyperreflectivity over drusen, drusen cores, and hyper- or hyporeflectivity of drusen were also associated with RPE atrophy. Conclusions: Macular pathologies in AMD can be qualitatively and reproducibly evaluated with SD-OCT, identifying pathologic features that are associated with vision loss, RPE atrophy, and even possibly the presence of advanced AMD not apparent on CFP. Qualitative and detailed SD-OCT analysis can contribute to the anatomic characterization of AMD in clinical studies of vision loss and disease progression. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.",
author = "Leuschen, {Jessica N.} and Schuman, {Stefanie G.} and Winter, {Katrina P.} and McCall, {Michelle N.} and Wong, {Wai T.} and Chew, {Emily Y.} and Thomas Hwang and Sunil Srivastava and Neeru Sarin and Traci Clemons and Molly Harrington and Toth, {Cynthia A.}",
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AU - Wong, Wai T.

AU - Chew, Emily Y.

AU - Hwang, Thomas

AU - Srivastava, Sunil

AU - Sarin, Neeru

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AU - Harrington, Molly

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N2 - Purpose: Describe qualitative spectral-domain optical coherence tomography (SD-OCT) characteristics of eyes classified as intermediate age-related macular degeneration (nonadvanced AMD) from Age-Related Eye Disease Study 2 (AREDS2) color fundus photography (CFP) grading. Design: Prospective cross-sectional study. Participants: We included 345 AREDS2 participants from 4 study centers and 122 control participants who lack CFP features of intermediate AMD. Methods: Both eyes were imaged with SD-OCT and CFP. The SD-OCT macular volume scans were graded for the presence of 5 retinal, 5 subretinal, and 4 drusen characteristics. In all, 314 AREDS2 participants with ≥1 category-3 AMD eye and all controls each had 1 eye entered into SD-OCT analysis, with 63 eyes regraded to test reproducibility. Main Outcome Measures: We assessed SD-OCT characteristics at baseline. Results: In 98% of AMD eyes, SD-OCT grading of all characteristics was successful, detecting drusen in 99.7%, retinal pigment epithelium (RPE) atrophy/absence in 22.9%, subfoveal geographic atrophy in 2.5%, and fluid in or under the retina in 25.5%. Twenty-eight percent of AMD eyes had characteristics of possible advanced AMD on SD-OCT. Two percent of control eyes had drusen on SD-OCT. Vision loss was not correlated with foveal drusen alone, but with foveal drusen that were associated with other foveal pathology and with overlying focal hyperreflectivity. Focal hyperreflectivity over drusen, drusen cores, and hyper- or hyporeflectivity of drusen were also associated with RPE atrophy. Conclusions: Macular pathologies in AMD can be qualitatively and reproducibly evaluated with SD-OCT, identifying pathologic features that are associated with vision loss, RPE atrophy, and even possibly the presence of advanced AMD not apparent on CFP. Qualitative and detailed SD-OCT analysis can contribute to the anatomic characterization of AMD in clinical studies of vision loss and disease progression. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

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