AbstractsBiology & Animal Science

Abstract

Purpose: To use spectral domain optical coherence tomography (SD-OCT) to investigate risk factors predictive for the development of atrophy of drusenoid lesions (DLs) (drusen and drusenoid pigment epithelium detachment) in eyes with non-neovascular age-related macular degeneration (NNVAMD). Design: Cohort study. Participants: Forty-one eyes from 29 patients with NNVAMD. Methods: Patients with NNVAMD who underwent registered SD-OCT imaging over a minimum period of 6 months were reviewed. Drusenoid lesions that were accompanied by new atrophy onset at 6 months or last follow-up (FUL) were further analyzed. Detailed lesion change was described throughout the study period. Odds ratios (ORs) and risk for new local atrophy onset were calculated. Main Outcome Measures: Drusenoid lesion features and longitudinal changes in features, including maximum lesion height, lesion diameter, lesion internal reflectivity, and presence and extent of overlying intra- retinal hyperreflective foci (HRF). Subfoveal choroidal thickness (SFCT) and choroidal thickness (CT) were measured below each lesion. Results: A total of 543 individual DLs were identified at baseline, and 28 lesions developed during follow-up. The mean follow-up time was 21.3 ± 8.6 months (range, 6-44 months). Some 3.2%of DLs (18/571) progressed to atrophy within 18.3 ± 9.5 months (range, 5-28 months) of the initial visit. Drusenoid lesions with heterogeneous internal reflectivity were significantly associated with new atrophy onset at 6 months (OR, 5.614; 95% confidence interval [CI], 1.277-24.673) and new atrophy onset at FUL (OR, 7.005; 95% CI, 2.300-21.337). Lesions with the presence of HRF were significant predictors of new atrophy onset at 6 months (OR, 30.161; 95% CI, 4.766-190.860) and FUL (OR, 11.211; 95% CI, 2.513-50.019). Lesions with a baseline maximum height >80 µm or CT ≤ 135 µm showed a positive association with the new atrophy onset at FUL (OR, 7.886; 95% CI, 2.105-29.538 and OR, 3.796; 95% CI, 1.154-12.481, respectively). Conclusions: The presence of HRF overlying DLs, a heterogeneous internal reflectivity of these lesions, was found consistently to be predictive of local atrophy onset in the ensuing months. These findings provide further insight into the natural history of anatomic change occurring in patients with NNVAMD. Hintergrund: Ziel war es, die SD-OCT dazu zu verwenden, prädiktive Risikofaktoren für den Übergang von Drusen zu Atrophiezonen bei Augen mit trockener altersbedingter Makuladegeneration (AMD) zu untersuchen. Design: Kohortenstudie. Probanden: Einundvierzig Augen von 29 Patienten mit trockener AMD. Methoden: Wir untersuchten retrospektiv Patienten mit trockener AMD, die über mindestens 6 Monate mittels registrierter SD-OCT-Scans beobachtet wurden. Drusen im OCT, die sich nach 6 oder mehr Monaten zu Atrophiezonen entwickelten, wurden eingehend untersucht. Hierfür wurden Parameter wie maximale Höhe, Drusendurchmesser, interne Reflektivität, Dicke der Chorioidea und intraretinale hyperreflektive Foci (HRF) ausgewertet.…