Optical coherence tomography evidence of macular ganglion cell-inner plexiform layer thinning in eyes with subretinal drusenoid deposits

Abstract

Background/Objectives The purpose of this study was to evaluate macular ganglion cell layer-inner plexiform layer (GCL-IPL) and choroidal thickness in early age-related macular degeneration (AMD) in eyes with subretinal drusenoid deposits (SDD). Subjects/Methods Comprehensive ophthalmological examination was performed. Near infrared reflectance and raster images using enhanced depth imaging were acquired with spectral domain optical coherence tomography. Drusen and SDD were diagnosed based on raster scans and near infrared reflectance. GCL-IPL maps were generated with automated segmentation and choroidal thickness maps were obtained by manually delineating the choroid-scleral boundary. Results Forty-eight eyes from 48 patients (mean age 77.5 ± 5.7, range 68-90 years) with a diagnosis of early AMD and 42 eyes of 42 age-matched control subjects (mean age 76.9 ± 5.7, range 67-88 years) were included. Of these, 28 eyes (58.3%) had drusen alone, 4 eyes (8.3%) had SDD alone, and 16 eyes (33.3%) had drusen associated with SDD. Compared with controls, average choroidal thickness was significantly decreased in AMD eyes (P < 0.05). There was no significant difference in choroidal thickness in eyes with SDD with respect to those with drusen alone. GCL-IPL thickness was reduced in an annular pattern at the 3 and 6 mm macular areas in AMD patients with respect to controls (P < 0.05). GCL-IPL thickness at 3 mm was significantly reduced in eyes with SDD with respect to those with drusen alone (P = 0.03). Conclusions The GCL-IPL is reduced in thickness with an annular pattern in early AMD and is significantly thinner in eyes with SDD.

Macular Thickness in Intermediate Age-Related Macular Degeneration Is Influenced by Disease Severity and Subretinal Drusenoid Deposit Presence

“…These decrements in SDD eyes also persisted even after we excluded the eyes that developed non-central GA over 4 years. These findings provide support for previous reports of decreased retinal thickness in iAMD eyes with SDDs 12 , 32 , 34 – 36 and corroborate associations of SDDs with outer retinal thinning in the context of a preserved RPE, a description referred to as cORA (for complete outer retinal atrophy) in the OCT-based staging of AMD. 13 , 37 …”

“…These decrements in SDD eyes also persisted even after we excluded the eyes that developed non-central GA over 4 years. These findings provide support for previous reports of decreased retinal thickness in iAMD eyes with SDDs 12,32,[34][35][36] and corroborate associations of SDDs with outer retinal thinning in the context of a preserved RPE, a description referred to as cORA (for complete outer retinal atrophy) in the OCT-based staging of AMD. 13,37 Although progression to the late forms of AMD, including GA 38 and neovascular AMD, 39 has long been associated with marked decrements in central visual function, the functional consequences of changes in retinal thickness in the context of iAMD is less well characterized.…”

“…Past studies have used other segmentation methods such as the Spectralis OCT built-in software. 20,32 Given the small magnitude of the changes in retinal thickness, more studies are necessary to compare these methods to understand if our different findings can be attributed partially to differences in segmentation methods.…”

Characteristics of the inner retinal layer in the fellow eyes of patients with unilateral exudative age-related macular degeneration

“…The retinal and choroidal vascular characteristics in the fellow eyes of AMD patients showed differences according to the type of wet AMD. Abdolrahimzadeh et al [41] recently…”

The effect of topical bromfenac on intraretinal and subretinal fluid in neovascular age-related macular degeneration

“…It is clearly beyond the scope of this paper to draw conclusions on the efficacy of bromfenac on the types, size, and stages of neovascular AMD. 2 6 20 However, given that we studied an uncommon case where recommended anti-VEGF therapy could not be administered, our report could solicit future investigations to evaluate the dynamics of macular edema in the management of neovascular AMD. This could provide further knowledge and possibly open-targeted therapeutic strategies for the relentless management of this lifelong pathology.…”