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Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT.

Publication ,  Journal Article
Pasricha, MV; Tai, V; Sleiman, K; Winter, K; Chiu, SJ; Farsiu, S; Stinnett, SS; Lad, EM; Wong, WT; Chew, EY; Toth, CA ...
Published in: Ophthalmol Retina
May 2021

PURPOSE: In macula-wide analyses, spectral-domain (SD) optical coherence tomography (OCT) features including drusen volume, hyperreflective foci, and OCT-reflective drusen substructures independently predict geographic atrophy (GA) onset secondary to age-related macular degeneration (AMD). We sought to identify SD OCT features in the location of new GA before its onset. DESIGN: Retrospective study. PARTICIPANTS: Age-Related Eye Disease Study 2 Ancillary SD OCT Study participants. METHODS: We analyzed longitudinally captured SD OCT images and color photographs from 488 eyes of 488 participants with intermediate AMD at baseline. Sixty-two eyes with sufficient image quality demonstrated new-onset GA on color photographs during study years 2 through 7. The area of new-onset GA and one size-matched control region in the same eye were segmented separately, and corresponding spatial volumes on registered SD OCT images at the GA incident year and at 2, 3, and 4 years previously were defined. Differences in SD OCT features between paired precursor regions were evaluated through matched-pairs analyses. MAIN OUTCOME MEASURES: Localized SD OCT features 2 years before GA onset. RESULTS: Compared with paired control regions, GA precursor regions at 2, 3, and 4 years before (n = 54, 33, and 25, respectively) showed greater drusen volume (P = 0.01, P = 0.003, and P = 0.003, respectively). At 2 and 3 years before GA onset, they were associated with the presence of hypertransmission (P < 0.001 and P = 0.03, respectively), hyperreflective foci (P < 0.001 and P = 0.045, respectively), OCT-reflective drusen substructures (P = 0.004 and P = 0.03, respectively), and loss or disruption of the photoreceptor zone, ellipsoid zone, and retinal pigment epithelium (RPE, P < 0.001 and P = 0.005-0.045, respectively). At 4 years before GA onset, precursor regions were associated with photoreceptor zone thinning (P = 0.007) and interdigitation zone loss (P = 0.045). CONCLUSIONS: Evolution to GA is heralded by early local photoreceptor changes and drusen accumulation, detectable 4 years before GA onset. These precede other anatomic heralds such as RPE changes and drusen substructure emergence detectable 1 to 2 years before GA. This study thus identified earlier end points for GA as potential therapeutic targets in clinical trials.

Duke Scholars

Published In

Ophthalmol Retina

DOI

EISSN

2468-6530

Publication Date

May 2021

Volume

5

Issue

5

Start / End Page

396 / 408

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Time Factors
  • Retinal Pigment Epithelium
  • Prospective Studies
  • Middle Aged
  • Male
  • Macular Degeneration
  • Macula Lutea
  • Humans
  • Geographic Atrophy
 

Citation

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Pasricha, M. V., Tai, V., Sleiman, K., Winter, K., Chiu, S. J., Farsiu, S., … Age-Related Eye Disease Study 2 Ancillary Spectral-Domain Optical Coherence Tomography Study Group, . (2021). Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT. Ophthalmol Retina, 5(5), 396–408. https://doi.org/10.1016/j.oret.2020.12.010
Pasricha, Malini Veerappan, Vincent Tai, Karim Sleiman, Katrina Winter, Stephanie J. Chiu, Sina Farsiu, Sandra S. Stinnett, et al. “Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT.Ophthalmol Retina 5, no. 5 (May 2021): 396–408. https://doi.org/10.1016/j.oret.2020.12.010.
Pasricha MV, Tai V, Sleiman K, Winter K, Chiu SJ, Farsiu S, et al. Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT. Ophthalmol Retina. 2021 May;5(5):396–408.
Pasricha, Malini Veerappan, et al. “Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT.Ophthalmol Retina, vol. 5, no. 5, May 2021, pp. 396–408. Pubmed, doi:10.1016/j.oret.2020.12.010.
Pasricha MV, Tai V, Sleiman K, Winter K, Chiu SJ, Farsiu S, Stinnett SS, Lad EM, Wong WT, Chew EY, Toth CA, Age-Related Eye Disease Study 2 Ancillary Spectral-Domain Optical Coherence Tomography Study Group. Local Anatomic Precursors to New-Onset Geographic Atrophy in Age-Related Macular Degeneration as Defined on OCT. Ophthalmol Retina. 2021 May;5(5):396–408.
Journal cover image

Published In

Ophthalmol Retina

DOI

EISSN

2468-6530

Publication Date

May 2021

Volume

5

Issue

5

Start / End Page

396 / 408

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Time Factors
  • Retinal Pigment Epithelium
  • Prospective Studies
  • Middle Aged
  • Male
  • Macular Degeneration
  • Macula Lutea
  • Humans
  • Geographic Atrophy