Persistent Hypertransmission Defects Detected on En Face Swept Source Optical Computed Tomography Images Predict the Formation of Geographic Atrophy in Age-Related Macular Degeneration

Rita Laiginhas, Yingying Shi, Mengxi Shen, Xiaoshuang Jiang, William Feuer, Giovanni Gregori, Philip J. Rosenfeld

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)58-70
Number of pages13
JournalAmerican journal of ophthalmology
Volume237
DOIs
StatePublished - May 2022
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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