Rita Laiginhas1, Yingying Shi1, Mengxi Shen1, Xiaoshuang Jiang1, William Feuer1, Giovanni Gregori1, Philip J Rosenfeld2. 1. From the Department of Ophthalmology (R.L., Y.S., M.S., X.J., W.F., G.G., P.J.R.), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. 2. From the Department of Ophthalmology (R.L., Y.S., M.S., X.J., W.F., G.G., P.J.R.), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: prosenfeld@miami.edu.
Abstract
PURPOSE: To determine whether persistent hypertransmission defects (hyperTDs), previously shown to have a greatest linear dimension (GLD) ≥250 µm on en face swept source OCT (SS-OCT) images, serve as a stand-alone early biomarker for the future formation geographic atrophy (GA). DESIGN: Post hoc cohort study using a subgroup of a prospective study. METHODS: Patients with intermediate age-related macular degeneration (iAMD) underwent 6- × 6-mm SS-OCT raster scans at baseline and during their follow-up period. En face images were generated using a slab with segmentation boundaries positioned 64 µm to 400 µm beneath the Bruch's membrane. Two graders independently evaluated all en face structural images for the presence of hyperTDs with a GLD ≥250 µm and GA. RESULTS: A total of 190 eyes were included with a mean ± SD follow-up of 31 ± 13.2 months. At baseline, 31 eyes (16%) had at least 1 hyperTD ≥250 µm, and 13 eyes (42%) progressed to GA. In those eyes without a hyperTD ≥250 µm at baseline, 42 (26%) developed hyperTDs ≥250 µm during their follow-up, and 11 eyes (7%) progressed to GA. At the last available follow-up visit, 25 eyes (13%) progressed to GA and of these 25 eyes, a prior hyperTD ≥250 µm was detected in 24 eyes before GA formed. A time-dependent Cox-survival regression analysis estimated an 80-fold (95% CI, 10.7-614, P < .001) increased risk of developing GA once a hyperTD ≥250 µm appeared. CONCLUSIONS: Persistent hyperTDs detected on en face OCT images were shown to serve as an early stand-alone OCT biomarker for the future formation of GA.
PURPOSE: To determine whether persistent hypertransmission defects (hyperTDs), previously shown to have a greatest linear dimension (GLD) ≥250 µm on en face swept source OCT (SS-OCT) images, serve as a stand-alone early biomarker for the future formation geographic atrophy (GA). DESIGN: Post hoc cohort study using a subgroup of a prospective study. METHODS: Patients with intermediate age-related macular degeneration (iAMD) underwent 6- × 6-mm SS-OCT raster scans at baseline and during their follow-up period. En face images were generated using a slab with segmentation boundaries positioned 64 µm to 400 µm beneath the Bruch's membrane. Two graders independently evaluated all en face structural images for the presence of hyperTDs with a GLD ≥250 µm and GA. RESULTS: A total of 190 eyes were included with a mean ± SD follow-up of 31 ± 13.2 months. At baseline, 31 eyes (16%) had at least 1 hyperTD ≥250 µm, and 13 eyes (42%) progressed to GA. In those eyes without a hyperTD ≥250 µm at baseline, 42 (26%) developed hyperTDs ≥250 µm during their follow-up, and 11 eyes (7%) progressed to GA. At the last available follow-up visit, 25 eyes (13%) progressed to GA and of these 25 eyes, a prior hyperTD ≥250 µm was detected in 24 eyes before GA formed. A time-dependent Cox-survival regression analysis estimated an 80-fold (95% CI, 10.7-614, P < .001) increased risk of developing GA once a hyperTD ≥250 µm appeared. CONCLUSIONS: Persistent hyperTDs detected on en face OCT images were shown to serve as an early stand-alone OCT biomarker for the future formation of GA.
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