Frank G Holz1, SriniVas R Sadda2, Giovanni Staurenghi3, Moritz Lindner4, Alan C Bird5, Barbara A Blodi6, Ferdinando Bottoni3, Usha Chakravarthy7, Emily Y Chew8, Karl Csaky9, Christine A Curcio10, Ron Danis6, Monika Fleckenstein4, K Bailey Freund11, Juan Grunwald12, Robyn Guymer13, Carel B Hoyng14, Glenn J Jaffe15, Sandra Liakopoulos16, Jordi M Monés17, Akio Oishi4, Daniel Pauleikhoff18, Philip J Rosenfeld19, David Sarraf20, Richard F Spaide11, Ramin Tadayoni21, Adnan Tufail22, Sebastian Wolf23, Steffen Schmitz-Valckenberg4. 1. Department of Ophthalmology, University of Bonn, Bonn, Germany. Electronic address: Frank.Holz@ukb.uni-bonn.de. 2. Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California. 3. Eye Clinic, Department of Biomedical and Clinical Sciences "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy. 4. Department of Ophthalmology, University of Bonn, Bonn, Germany. 5. Institute of Ophthalmology, University College London, London, United Kingdom. 6. Department of Ophthalmology and Visual Sciences, Fundus Photograph Reading Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 7. Institute of Clinical Science, The Queen's University of Belfast, Belfast, United Kingdom. 8. National Eye Institute, National Institutes of Health, Bethesda, Maryland. 9. Texas Retina Associates, Dallas, Texas. 10. Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama. 11. Vitreous Retina Macula Consultants of New York, New York, New York. 12. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. 13. Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Department of Surgery (Ophthalmology) Melbourne, Australia. 14. Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands. 15. Department of Ophthalmology, Duke Reading Center, Duke University, Durham, North Carolina. 16. Department of Ophthalmology, Cologne Image Reading Center, University of Cologne, Cologne, Germany. 17. Institut de la Màcula and Barcelona Macula Foundation, Barcelona, Spain. 18. Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany. 19. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. 20. Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California. 21. Ophthalmology Department, Hôpital Lariboisière, AP-HP, Université Paris 7 - Sorbonne Paris Cité, Paris, France. 22. Moorfields Eye Hospital, London, United Kingdom. 23. Department of Ophthalmology, University Hospital Bern, University of Bern, Bern, Switzerland.
Abstract
PURPOSE: To summarize the results of 2 consensus meetings (Classification of Atrophy Meeting [CAM]) on conventional and advanced imaging modalities used to detect and quantify atrophy due to late-stage non-neovascular and neovascular age-related macular degeneration (AMD) and to provide recommendations on the use of these modalities in natural history studies and interventional clinical trials. DESIGN: Systematic debate on the relevance of distinct imaging modalities held in 2 consensus meetings. PARTICIPANTS: A panel of retina specialists. METHODS: During the CAM, a consortium of international experts evaluated the advantages and disadvantages of various imaging modalities on the basis of the collective analysis of a large series of clinical cases. A systematic discussion on the role of each modality in future studies in non-neovascular and neovascular AMD was held. MAIN OUTCOME MEASURES: Advantages and disadvantages of current retinal imaging technologies and recommendations for their use in advanced AMD trials. RESULTS: Imaging protocols to detect, quantify, and monitor progression of atrophy should include color fundus photography (CFP), confocal fundus autofluorescence (FAF), confocal near-infrared reflectance (NIR), and high-resolution optical coherence tomography volume scans. These images should be acquired at regular intervals throughout the study. In studies of non-neovascular AMD (without evident signs of active or regressed neovascularization [NV] at baseline), CFP may be sufficient at baseline and end-of-study visit. Fluorescein angiography (FA) may become necessary to evaluate for NV at any visit during the study. Indocyanine-green angiography (ICG-A) may be considered at baseline under certain conditions. For studies in patients with neovascular AMD, increased need for visualization of the vasculature must be taken into account. Accordingly, these studies should include FA (recommended at baseline and selected follow-up visits) and ICG-A under certain conditions. CONCLUSIONS: A multimodal imaging approach is recommended in clinical studies for the optimal detection and measurement of atrophy and its associated features. Specific validation studies will be necessary to determine the best combination of imaging modalities, and these recommendations will need to be updated as new imaging technologies become available in the future.
PURPOSE: To summarize the results of 2 consensus meetings (Classification of Atrophy Meeting [CAM]) on conventional and advanced imaging modalities used to detect and quantify atrophy due to late-stage non-neovascular and neovascular age-related macular degeneration (AMD) and to provide recommendations on the use of these modalities in natural history studies and interventional clinical trials. DESIGN: Systematic debate on the relevance of distinct imaging modalities held in 2 consensus meetings. PARTICIPANTS: A panel of retina specialists. METHODS: During the CAM, a consortium of international experts evaluated the advantages and disadvantages of various imaging modalities on the basis of the collective analysis of a large series of clinical cases. A systematic discussion on the role of each modality in future studies in non-neovascular and neovascular AMD was held. MAIN OUTCOME MEASURES: Advantages and disadvantages of current retinal imaging technologies and recommendations for their use in advanced AMD trials. RESULTS: Imaging protocols to detect, quantify, and monitor progression of atrophy should include color fundus photography (CFP), confocal fundus autofluorescence (FAF), confocal near-infrared reflectance (NIR), and high-resolution optical coherence tomography volume scans. These images should be acquired at regular intervals throughout the study. In studies of non-neovascular AMD (without evident signs of active or regressed neovascularization [NV] at baseline), CFP may be sufficient at baseline and end-of-study visit. Fluorescein angiography (FA) may become necessary to evaluate for NV at any visit during the study. Indocyanine-green angiography (ICG-A) may be considered at baseline under certain conditions. For studies in patients with neovascular AMD, increased need for visualization of the vasculature must be taken into account. Accordingly, these studies should include FA (recommended at baseline and selected follow-up visits) and ICG-A under certain conditions. CONCLUSIONS: A multimodal imaging approach is recommended in clinical studies for the optimal detection and measurement of atrophy and its associated features. Specific validation studies will be necessary to determine the best combination of imaging modalities, and these recommendations will need to be updated as new imaging technologies become available in the future.
Authors: Jason N Crosson; Thomas A Swain; Mark E Clark; Carrie E Huisingh; Gerald McGwin; Cynthia Owsley; Christine A Curcio Journal: Ophthalmol Retina Date: 2019-03-30
Authors: Robyn H Guymer; Philip J Rosenfeld; Christine A Curcio; Frank G Holz; Giovanni Staurenghi; K Bailey Freund; Steffen Schmitz-Valckenberg; Janet Sparrow; Richard F Spaide; Adnan Tufail; Usha Chakravarthy; Glenn J Jaffe; Karl Csaky; David Sarraf; Jordi M Monés; Ramin Tadayoni; Juan Grunwald; Ferdinando Bottoni; Sandra Liakopoulos; Daniel Pauleikhoff; Sergio Pagliarini; Emily Y Chew; Francesco Viola; Monika Fleckenstein; Barbara A Blodi; Tock Han Lim; Victor Chong; Jerry Lutty; Alan C Bird; Srinivas R Sadda Journal: Ophthalmology Date: 2019-09-30 Impact factor: 12.079
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Authors: Karl G Csaky; Praveen J Patel; Yasir J Sepah; David G Birch; Diana V Do; Michael S Ip; Robyn H Guymer; Chi D Luu; Shamika Gune; Hugh Lin; Daniela Ferrara Journal: Surv Ophthalmol Date: 2019-01-28 Impact factor: 6.048
Authors: Christopher K Hwang; Elvira Agrón; Amitha Domalpally; Catherine A Cukras; Wai T Wong; Emily Y Chew; Tiarnan D L Keenan Journal: Ophthalmol Retina Date: 2020-10-16