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Optical coherence tomography-based correlation between choroidal thickness and drusen load in dry age-related macular degeneration.

ABSTRACT: Spectral domain optical coherence tomography can be used to measure both choroidal thickness and drusen load. The authors conducted an exploratory study using spectral domain optical coherence tomography to determine if a correlation between choroidal thickness and drusen load exists in patients with dry age-related macular degeneration.Forty-four patients with dry age-related macular degeneration were recruited. The drusen area and volume were determined using the automated software algorithm of the spectral domain optical coherence tomography device, and choroidal thickness was measured using enhanced depth imaging. Correlations were determined using multivariable and univariable analyses.The authors found an inverse correlation between choroidal thickness and drusen load (r = -0.35, P = 0.04). Drusen load was also correlated with visual acuity (r = 0.32, P = 0.04). A correlation between choroidal thickness and visual acuity was suggested (r = -0.22, P = 0.21).Spectral domain optical coherence tomography can be used to assess the correlation between drusen load and choroidal thickness, both of which show a relationship with visual acuity. The measurement of these outcomes may serve as important outcome parameters in routine clinical care and in clinical trials for patients with dry age-related macular degeneration.

SUBMITTER: Ko A

PROVIDER: S-EPMC3947382 | biostudies-other | 2013 May

REPOSITORIES: biostudies-other

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Optical coherence tomography-based correlation between choroidal thickness and drusen load in dry age-related macular degeneration.

Ko Ashley A Cao Sijia S Pakzad-Vaezi Kaivon K Brasher Penelope M PM Merkur Andrew B AB Albiani David A DA Kirker Andrew W AW Cui Jing J Matsubara Joanne J Forooghian Farzin F

Retina (Philadelphia, Pa.) 20130501 5

<h4>Purpose</h4>Spectral domain optical coherence tomography can be used to measure both choroidal thickness and drusen load. The authors conducted an exploratory study using spectral domain optical coherence tomography to determine if a correlation between choroidal thickness and drusen load exists in patients with dry age-related macular degeneration.<h4>Methods</h4>Forty-four patients with dry age-related macular degeneration were recruited. The drusen area and volume were determined using th ...[more]

PMID: 23474546

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Project description:PurposeTo detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography.DesignObservational, cross-sectional study.ParticipantsA total of 5 normal subjects and 5 subjects with neovascular AMD were included.MethodsA total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3 × 3-mm area and comprised 200 × 200 × 8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by 3-dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2-dimensional angiograms from the 3 layers. The CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views.Main outcome measuresThe CNV angiogram, CNV area, and CNV flow index.ResultsEn face OCT angiograms of CNV showed sizes and locations that were confirmed by fluorescein angiography (FA). Optical coherence tomography angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in 1 case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch's layer and classify type I and type II CNV. A feeder vessel could be identified in 1 case. Higher flow indexes were associated with larger CNV and type II CNV.ConclusionsOptical coherence tomography angiography provides depth-resolved information and detailed images of CNV in neovascular AMD. Quantitative information regarding CNV flow and area can be obtained. Further studies are needed to assess the role of quantitative OCT angiography in the evaluation and treatment of neovascular AMD.

Project description:PurposeStructural and compositional heterogeneity within drusen comprising lipids, carbohydrates, and proteins have been previously described. We sought to detect and define phenotypic patterns of drusen heterogeneity in the form of optical coherence tomography-reflective drusen substructures (ODS) and examine their associations with age-related macular degeneration (AMD)-related features and AMD progression.DesignRetrospective analysis in a prospective study.ParticipantsPatients with intermediate AMD (n = 349) enrolled in the multicenter Age-Related Eye Disease Study 2 (AREDS2) ancillary spectral-domain optical coherence tomography (SD OCT) study.MethodsBaseline SD OCT scans of 1 eye per patient were analyzed for the presence of ODS. Cross-sectional and longitudinal associations of ODS presence with AMD-related features visible on SD OCT and color photographs, including drusen volume, geographic atrophy (GA), and preatrophic features, were evaluated for the entire macular region. Similar associations were also made locally within a 0.5-mm-diameter region around individual ODS and corresponding control region without ODS in the same eye.Main outcome measuresPreatrophy SD OCT changes and GA, central GA, and choroidal neovascularization (CNV) from color photographs.ResultsFour phenotypic subtypes of ODS were defined: low reflective cores, high reflective cores, conical debris, and split drusen. Among the 349 participants, there were 307 eligible eyes and 74 (24%) had at least 1 ODS. The ODS at baseline were associated with (1) greater macular drusen volume at baseline (P < 0.001), (2) development of preatrophic changes at year 2 (P = 0.001-0.01), and (3) development of macular GA (P = 0.005) and preatrophic changes at year 3 (P = 0.002-0.008), but not development of CNV. The ODS at baseline in a local region were associated with (1) presence of preatrophy changes at baseline (P = 0.02-0.03) and (2) development of preatrophy changes at years 2 and 3 within the region (P = 0.008-0.05).ConclusionsOptical coherence tomography-reflective drusen substructures are optical coherence tomography-based biomarkers of progression to GA, but not to CNV, in eyes with intermediate AMD. Optical coherence tomography-reflective drusen substructures may be a clinical entity helpful in monitoring AMD progression and informing mechanisms in GA pathogenesis.

Project description:ObjectiveTo compare peripapillary and macular choroidal thickness (PCT and MCT) between open-angle glaucoma (OAG) and normal controls using swept-source optical coherence tomography (SS-OCT), and to evaluate global and localized relationships between choroidal thickness and various factors in OAG, also using SS-OCT.MethodsIn this cross-sectional comparative study, 134 OAG patients and 73 normal controls were examined. PCT (global, 12 clock-hour sectors), MCT (global, six sectors) were measured by SS-OCT. The difference in choroidal thickness between the OAG patients and the normal controls was analyzed. The relationships between choroidal thickness and various factors including age, sex, spherical equivalent (SE), axial length (AXL), central corneal thickness (CCT), intraocular pressure (IOP), peripapillary retinal nerve fiber layer thickness (pRNFLT), visual field mean deviation (MD), ganglion cell-inner plexiform layer thickness (GCIPLT), and disc area were analyzed by univariate and multivariate linear regression. Global and regional analyses were performed in 12 segments of the peripapillary circle and in six sectors of the macula.ResultsThere were significant differences in global PCT and MCT between the OAG patients and the normal controls (115.22±41.17 vs. 138.89±44.70, P<0.001), (184.36±57.15 vs. 209.25±61.11, P = 0.004). The difference in global PCT remained, both after adjusting for age, AXL (117.08±3.45 vs. 135.47±4.70, P = 0.002) and also after adjusting for age, AXL, disc area (117.46±3.46 vs. 135.67±4.67, P = 0.002). But the difference in global MCT did not remain after adjusting for age, AXL, SE (188.18±4.46 vs. 202.25±6.08, P = 0.066). PCT showed significant differences between the groups in all of the 12 clock-hour sectors. These differences remained after adjusting for age, AXL and for age, AXL, disc area, with the exception of the 10 o'clock (o/c) sector. MCT in six sectors showed differences between the two groups, but they did not remain after adjusting for age, AXL, SE. In a multivariate regression analysis of the OAG patients, global PCT showed correlations with age (? = -1.18, P = 0.001), AXL (? = -14.01, P<0.001), and disc area (? = -16.67, P = 0.026). Global MCT, meanwhile, showed a significant correlation with age (? = -1.92, P<0.001), AXL. (? = -21.97, P<0.001). Choroidal thickness did not show any global or localized relationship with glaucoma severity in the OAG patients.ConclusionsThe global and all 12 clock-hour PCT, with the exception of the 10 o/c sector, were thinner in OAG; however, they did not show any correlation with glaucoma severity. Possible roles of PCT in glaucoma pathogenesis should be investigated further.

Dataset Information

Optical coherence tomography-based correlation between choroidal thickness and drusen load in dry age-related macular degeneration.

Publications

Optical coherence tomography-based correlation between choroidal thickness and drusen load in dry age-related macular degeneration.

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