Optical Coherence Tomography and Autofluorescence Findings in Areas with Geographic Atrophy Due to Age-Related Macular Degeneration

Schmitz-Valckenberg, Steffen; Fleckenstein, Monika; Göbel, Arno P.; Hohman, Thomas C.; Holz, Frank G.

doi:10.1167/iovs.10-5619

Cited by 90 publications

(79 citation statements)

References 32 publications

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“…14-17 SD-OCT has identified subretinal drusenoid deposits and abnormalities of the RPE and photoreceptors at the margins of GA that may be associated with the expansion of GA. [17][18][19][20][21][22] However, none of these imaging strategies have reliably predicted an area in the macula where GA is likely to appear or predicted the growth of GA over 1 year once it appears. To help predict where GA is likely to appear and grow, investigators have relied on functional testing of the retina.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

Nunes¹,

Gregori²,

Yehoshua³

et al. 2013

Ophthalmic Surg Lasers Imaging Retina

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BACKGROUND AND OBJECTIVE: Spectral-domain optical coherence tomography (SD-OCT) en face imaging was used to measure the growth of geographic atrophy (GA) and identify baseline anatomic changes in the outer retina in eyes with nonexudative age-related macular degeneration (AMD). PATIENTS AND METHODS: In this prospective study, eyes were imaged using 200 × 200 and 512 × 128 A-scan raster patterns. Outer retinal anatomy was visualized using en face imaging of a 20-μm thick slab encompassing the inner segment/outer segment (IS/OS) band. RESULTS: En face SD-OCT imaging of the IS/OS region revealed a bilaterally symmetrical pattern of outer retinal disruption extending beyond the borders of GA that accurately predicted the progression of GA over 1 year in 13 of 30 eyes (43.3%). In the remaining cases, the area of disruption was much larger than the area of progression. CONCLUSION: En face imaging of the outer retina can predict the growth of GA in some eyes. Due to the bilateral symmetry of these findings, this imaging strategy may identify a genetic subset of patients in whom photoreceptor loss precedes the progression of GA. These areas with outer retinal disruption should be followed in clinical trials designed to test treatments for dry AMD. [ Ophthalmic Surg Lasers Imaging Retina. 2013;44:344–359.]

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Section: Introductionmentioning

confidence: 99%

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

Nunes¹,

Gregori²,

Yehoshua³

et al. 2013

Ophthalmic Surg Lasers Imaging Retina

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“…[14][15][16][17][18] A common finding within the atrophic lesions is the absence of the outer nuclear layer, as well as the absence of SD-OCT bands 1, 2, 3, and 4, which correspond to anatomical layers including the external limiting membrane, the inner-segment/outer-segment layer, and the RPE-Bruch's membrane complex. 15 Schmitz-Valckenberg et al 19 compared the fundus autofluorescence and SD-OCT appearance of eyes with GA and showed that the mean length of an atrophic lesion measured on the fundus autofluorescence image had the closest agreement with the appearance of choroidal hyperreflectivity on the SD-OCT B-scan, and the reduction of the fundus autofluorescence signal seen from GA was spatially correlated with the abrupt transition on the SD-OCT B-scan from a hyporeflective choroid to a hyperreflective choroid. This increased penetration of light below Bruch's membrane is presumably due to the loss of the RPE and choriocapillaris.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Geographic Atrophy Measurements from the OCT Fundus Image and the Sub-RPE Slab Image

Yehoshua¹,

Filho²,

Penha³

et al. 2013

Ophthalmic Surg Lasers Imaging Retina

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PURPOSE: To compare two different approaches to measuring areas of geographic atrophy (GA) using spectral-domain optical coherence tomography (SD-OCT). METHODS: Fifty eyes with GA were imaged with an SD-OCT instrument. OCT fundus images and sub– retinal pigment epithelium (RPE) slab images were generated. Three graders manually drew the GA boundaries on both en face images. An automated algorithm was used to segment the GA boundaries from the sub-RPE slabs. RESULTS: The agreement between the three manual measurements on both OCT fundus images (ICC = .998) and sub-RPE slabs (ICC = .999) was excellent. Area measurements from OCT fundus images and sub-RPE slabs were highly correlated. The agreement between manual and automated measurements on the sub-RPE slabs was very good (ICC = .795). CONCLUSION: Both OCT fundus images and sub-RPE slab images proved useful for measuring GA in age-related macular degeneration. The automated algorithm typically provided useful measurements of GA area from the sub-RPE slabs. [ Ophthalmic Surg Lasers Imaging Retina . 2013;44:127–132]

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“…Using simultaneous spectral-domain optical coherence tomography (SD-OCT) imaging, it was later confirmed that atrophic areas of severely reduced FAF intensities are spatially confined to loss of outer retinal layers with choroidal hypertransmission by SD-OCT [54] . Us-ing SD-OCT imaging for atrophy quantification obviously offers the advantage of using one device and one modality for the visualization of different retinal layers.…”

Section: Definitions Of "Geographic Atrophy" In Natural History Studiesmentioning

confidence: 96%

The Journey of “Geographic Atrophy” through Past, Present, and Future

Schmitz-Valckenberg¹

2017

Ophthalmologica

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“Geographic atrophy” is a concise term that has been firmly established for the description of the end-stage manifestation of nonexudative age-related macular degeneration (AMD). “Geographic lesions” resembling sharply demarcated continents on a map have been originally described in the German literature in 1854 (landkartenartiger/inselförmiger Zungenfratt) for a manifestation later called “geographic tongue” in English. In 1970, Gass was the first to describe “geographic areas of atrophy” in “senile macular choroidal degeneration.” Within a decade, the disease itself was named “geographic atrophy.” Today, various meanings of the term are used in parallel both in research and in routine clinical care. Currently, we are on the verge of better understanding the different forms of atrophy development, manifestation, and progression in AMD, which will pave the way for a more rational approach to their nomenclature and classification.

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Optical Coherence Tomography and Autofluorescence Findings in Areas with Geographic Atrophy Due to Age-Related Macular Degeneration

Cited by 90 publications

References 32 publications

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

Comparison of Geographic Atrophy Measurements from the OCT Fundus Image and the Sub-RPE Slab Image

The Journey of “Geographic Atrophy” through Past, Present, and Future

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