Tracking Progression with Spectral-Domain Optical Coherence Tomography in Geographic Atrophy Caused by Age-Related Macular Degeneration

被引:95
作者
Fleckenstein, Monika [1 ]
Schmitz-Valckenberg, Steffen [1 ]
Adrion, Christine [2 ]
Kraemer, Irene [1 ]
Eter, Nicole [1 ]
Helb, Hans Martin [1 ]
Brinkmann, Christian K. [1 ]
Issa, Peter Charbel [1 ,3 ]
Mansmann, Ulrich [2 ]
Holz, Frank G. [1 ]
机构
[1] Univ Bonn, Dept Ophthalmol, D-53127 Bonn, Germany
[2] Univ Munich, Dept Med Informat Biometry & Epidemiol, Munich, Germany
[3] Univ Oxford, Nuffield Lab Ophthalmol, Oxford OX2 6AW, England
关键词
FUNDUS AUTOFLUORESCENCE PATTERNS; DISEASE PROGRESSION; NATURAL-HISTORY; JUNCTIONAL ZONE; CLINICAL-TRIALS; HIGH-RISK; IN-VIVO; MACULOPATHY; EYE; OCT;
D O I
10.1167/iovs.09-4533
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE. To investigate, with the use of spectral-domain optical coherence tomography (SD-OCT), microstructural alterations over time in eyes with progressive geographic atrophy (GA) due to age-related macular degeneration. METHODS. Forty-six eyes of 26 patients (median age, 77.9 years [interquartile range (IQR), 71.8-81.0]) with GA without evidence of active or previous neovascular disease at baseline were examined by simultaneous confocal scanning laser ophthalmoscopy (cSLO) and SD-OCT. Serial examinations with alignment of follow-up to baseline scans were performed over a median period of 12.2 months (IQR, 10.2-15.3). Longitudinal SD-OCT variations were evaluated, including quantification of retinal thickness (RT) change and lateral spread of GA (LSGA) at a temporal, nasal, inferior, and superior GA border-section in each eye. RESULTS. GA-enlargement was characterized by progressive loss of the outer hyperreflective SD-OCT bands and by thinning of the outer nuclear layer with subsequent approach of the outer plexiform layer toward Bruch's membrane. In the perilesional zone, various dynamic changes were recorded, including migration of hyperreflective material and changes in drusen height. At the borders, there was a median RT change of -14.09 mu m/y (IQR -26.21 to -7.48 mu m/y). The median LSGA was 106.90 mu m/y (IQR, 55.44-161.70 mu m/y). Both parameters showed only moderate intraocular agreement (RT change: intraclass correlation coefficient [ICC], 0.54; 95% CI, 0.39-0.67; LSGA: ICC, 0.49; 95% CI, 0.34-0.64) and no statistical significant difference for one location (RT change, P = 0.125; LSGA, P = 0.516; likelihood ratio test). CONCLUSIONS. Combined cSLO and SD-OCT imaging provides unprecedented insight into dynamic microstructural changes of GA enlargement that may help to better understand the pathogenesis of the disease. Quantitative progression data indicate local factors may exist that drive progression in junctional areas (ClinicalTrials.gov number, NCT00393692). (Invest Ophthalmol Vis Sci. 2010; 51: 3846-3852) DOI: 10.1167/iovs.09-4533
引用
收藏
页码:3846 / 3852
页数:7
相关论文
共 49 条
[1]   Age-related macular degeneration: Etiology, pathogenesis, and therapeutic strategies [J].
Ambati, J ;
Ambati, BK ;
Yoo, SH ;
Ianchulev, S ;
Adamis, AP .
SURVEY OF OPHTHALMOLOGY, 2003, 48 (03) :257-293
[2]   Prevalence of age-related maculopathy in older Europeans - The European Eye Study (EUREYE) [J].
Augood, CA ;
Vingerling, JR ;
de Jong, PTVM ;
Chakravarthy, U ;
Seland, J ;
Soubrane, G ;
Tomazzoli, L ;
Topouzis, F ;
Bentham, G ;
Rahu, M ;
Vioque, J ;
Young, IS ;
Fletcher, AE .
ARCHIVES OF OPHTHALMOLOGY, 2006, 124 (04) :529-535
[3]   Spectral Domain Optical Coherence Tomography Imaging of Geographic Atrophy Margins [J].
Bearelly, Srilaxmi ;
Chau, Felix Y. ;
Koreishi, Anjum ;
Stinnett, Sandra S. ;
Izatt, Joseph A. ;
Toth, Cynthia A. .
OPHTHALMOLOGY, 2009, 116 (09) :1762-1769
[4]   Classification of abnormal fundus autofluorescence patterns in the junctional zone of geographic atrophy in patients with age related macular degeneration [J].
Bindewald, A ;
Schmitz-Valckenberg, S ;
Jorzik, JJ ;
Dolar-Szczasny, J ;
Sieber, H ;
Keilhauer, C ;
Weinberger, AWA ;
Dithmar, S ;
Pauleikhoff, D ;
Mansmann, U ;
Wolf, S ;
Holz, FG .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2005, 89 (07) :874-878
[5]   Correlation between Spectral-Domain Optical Coherence Tomography and Fundus Autofluorescence at the Margins of Geographic Atrophy [J].
Brar, Manpreet ;
Kozak, Igor ;
Cheng, Lingyun ;
Bartsch, Dirk-Uwe G. ;
Yuson, Ritchie ;
Nigam, Nitin ;
Oster, Stephen F. ;
Mojana, Francesca ;
Freeman, William R. .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 2009, 148 (03) :439-444
[6]   Cigarette smoking and age-related macular degeneration in the EUREYE study [J].
Chakravarthy, U. ;
Augood, C. ;
Bentham, G. C. ;
de Jong, P. T. V. M. ;
Rahu, M. ;
Seland, J. ;
Soubrane, G. ;
Tomazzoli, L. ;
Topouzis, F. ;
Vingerling, J. R. ;
Vioque, J. ;
Young, I. S. ;
Fletcher, A. E. .
OPHTHALMOLOGY, 2007, 114 (06) :1157-1163
[7]   Improved signal-to-noise ratio in spectral-domain compared with time-domain optical coherence tomography [J].
de Boer, JF ;
Cense, B ;
Park, BH ;
Pierce, MC ;
Tearney, GJ ;
Bouma, BE .
OPTICS LETTERS, 2003, 28 (21) :2067-2069
[8]   Automated analysis of digital fundus autofluorescence images of geographic atrophy in advanced age-related macular degeneration using confocal scanning laser ophthalmoscopy (cSLO) [J].
Deckert A. ;
Schmitz-Valckenberg S. ;
Jorzik J. ;
Bindewald A. ;
Holz F.G. ;
Mansmann U. .
BMC Ophthalmology, 5 (1)
[9]   Ultrahigh-resolution optical coherence tomography [J].
Drexler, W .
JOURNAL OF BIOMEDICAL OPTICS, 2004, 9 (01) :47-74
[10]  
Drexler Wolfgang, 2007, Invest Ophthalmol Vis Sci, V48, P5339