OCT-Defined Atrophic Age-Related Macular Degeneration Changes Associated with Deep Visual Sensitivity Losses: A Multicenter Study

IF 4.6 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-07-16 DOI:10.1016/j.xops.2025.100884

Zhichao Wu BAppSc(Optom), PhD , Barbara A. Blodi MD , Frank G. Holz MD , Glenn J. Jaffe MD , Sandra Liakopoulos MD , Srinivas R. Sadda MD , Steffen Schmitz-Valckenberg MD , Mari Bonse BSc , Tyler Brown COA , John Choong BS , Bailey Clifton COA , Giulia Corradetti MD , Lauren A.B. Hodgson MPH , Anna M. Lentzsch MD , Alireza Mahmoudi MD , Jeong W. Pak PhD , Marlene Saßmannshausen MD , Cindy Skalak RN, COT , Leon von der Emde MD , Jordan Winkler BSc , Robyn H. Guymer MBBS, PhD

{"title":"OCT-Defined Atrophic Age-Related Macular Degeneration Changes Associated with Deep Visual Sensitivity Losses: A Multicenter Study","authors":"Zhichao Wu BAppSc(Optom), PhD , Barbara A. Blodi MD , Frank G. Holz MD , Glenn J. Jaffe MD , Sandra Liakopoulos MD , Srinivas R. Sadda MD , Steffen Schmitz-Valckenberg MD , Mari Bonse BSc , Tyler Brown COA , John Choong BS , Bailey Clifton COA , Giulia Corradetti MD , Lauren A.B. Hodgson MPH , Anna M. Lentzsch MD , Alireza Mahmoudi MD , Jeong W. Pak PhD , Marlene Saßmannshausen MD , Cindy Skalak RN, COT , Leon von der Emde MD , Jordan Winkler BSc , Robyn H. Guymer MBBS, PhD","doi":"10.1016/j.xops.2025.100884","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To identify combination(s) of OCT changes that define atrophic age-related macular degeneration (AMD) lesions associated with repeatable deep visual sensitivity defects.</div></div><div><h3>Design</h3><div>Reader study.</div></div><div><h3>Participants</h3><div>One hundred seventy-one OCT scans from 60 eyes of 53 participants.</div></div><div><h3>Methods</h3><div>Participants underwent 2 high-density targeted microperimetry tests (Macular Integrity Assessment device with Goldmann Size III stimuli) per visit of a 3.5° (approximately 1000 μm) diameter region-of-interest that had evidence of at least incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA). OCT B-scans within the region sampled on microperimetry were annotated by 12 readers from 6 established reading centers for 7 different features related to RPE and outer retinal atrophy. The prevalence of the presence of a repeatable ≤10 decibel (dB) defect on microperimetry for lesions categorized by 18 different combinations of such features, or criteria, was determined.</div></div><div><h3>Main Outcome Measures</h3><div>The criteria for OCT-defined atrophic changes showing a ≥90% prevalence of a repeatable ≤10 dB defect, which has previously shown to be characteristic of regions with a truly nonresponding test location on microperimetry.</div></div><div><h3>Results</h3><div>Sixty percent of complete RPE and outer retinal atrophy (cRORA) lesions—based on the presence of hypertransmission and RPE abnormalities ≥250 μm in width, with evidence of overlying photoreceptor (PR) degeneration, on an OCT B-scan—had a repeatable ≤10 dB defect. However, between 92% and 98% of lesions with both hypertransmission and complete RPE loss ≥500 μm, and with evidence of any size of any feature of overlying PR degeneration, had a repeatable ≤10 dB defect, depending on the criteria considered. Between 92% and 95% of lesions with hypertransmission ≥500 μm and either overlying external limiting membrane disruption, or outer plexiform layer and inner nuclear layer subsidence, and/or hyporeflective wedge-shaped band(s) ≥500 μm, with or without RPE abnormalities, had a repeatable ≤10 dB defect.</div></div><div><h3>Conclusions</h3><div>This study identified various criteria for OCT-defined atrophic AMD lesions with functional characteristics that can be expected of regions with a truly nonresponding test location on high-density targeted microperimetry testing (i.e., having a ≥90% prevalence of a repeatable ≤10 dB defect). Such OCT-defined lesions could thus serve as functionally relevant clinical endpoints of end-stage atrophic AMD to facilitate preventative treatment trials.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 6","pages":"Article 100884"},"PeriodicalIF":4.6000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525001824","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To identify combination(s) of OCT changes that define atrophic age-related macular degeneration (AMD) lesions associated with repeatable deep visual sensitivity defects.

Design

Reader study.

Participants

One hundred seventy-one OCT scans from 60 eyes of 53 participants.

Methods

Participants underwent 2 high-density targeted microperimetry tests (Macular Integrity Assessment device with Goldmann Size III stimuli) per visit of a 3.5° (approximately 1000 μm) diameter region-of-interest that had evidence of at least incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA). OCT B-scans within the region sampled on microperimetry were annotated by 12 readers from 6 established reading centers for 7 different features related to RPE and outer retinal atrophy. The prevalence of the presence of a repeatable ≤10 decibel (dB) defect on microperimetry for lesions categorized by 18 different combinations of such features, or criteria, was determined.

Main Outcome Measures

The criteria for OCT-defined atrophic changes showing a ≥90% prevalence of a repeatable ≤10 dB defect, which has previously shown to be characteristic of regions with a truly nonresponding test location on microperimetry.

Results

Sixty percent of complete RPE and outer retinal atrophy (cRORA) lesions—based on the presence of hypertransmission and RPE abnormalities ≥250 μm in width, with evidence of overlying photoreceptor (PR) degeneration, on an OCT B-scan—had a repeatable ≤10 dB defect. However, between 92% and 98% of lesions with both hypertransmission and complete RPE loss ≥500 μm, and with evidence of any size of any feature of overlying PR degeneration, had a repeatable ≤10 dB defect, depending on the criteria considered. Between 92% and 95% of lesions with hypertransmission ≥500 μm and either overlying external limiting membrane disruption, or outer plexiform layer and inner nuclear layer subsidence, and/or hyporeflective wedge-shaped band(s) ≥500 μm, with or without RPE abnormalities, had a repeatable ≤10 dB defect.

Conclusions

This study identified various criteria for OCT-defined atrophic AMD lesions with functional characteristics that can be expected of regions with a truly nonresponding test location on high-density targeted microperimetry testing (i.e., having a ≥90% prevalence of a repeatable ≤10 dB defect). Such OCT-defined lesions could thus serve as functionally relevant clinical endpoints of end-stage atrophic AMD to facilitate preventative treatment trials.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

oct定义的萎缩性年龄相关性黄斑变性变化与深度视觉敏感性丧失相关：一项多中心研究

目的：鉴别与可重复深度视觉敏感性缺陷相关的萎缩性年龄相关性黄斑变性（AMD）病变的OCT变化组合。DesignReader研究。对53名参与者的60只眼睛进行了171次OCT扫描。方法：参与者在3.5°（约1000 μm）直径的感兴趣区域（至少有视网膜色素上皮不完整（RPE）和视网膜外萎缩（iRORA）的证据）进行两次高密度靶向显微镜检查（Goldmann Size III刺激的黄斑完整性评估装置）。来自6个已建立的阅读中心的12名读者对与RPE和外视网膜萎缩相关的7种不同特征进行了注释。通过18种不同的特征或标准组合分类的病变，显微镜检查确定了可重复≤10分贝（dB）缺陷的患病率。oct定义的萎缩变化的标准显示可重复≤10 dB缺陷的发生率≥90%，这先前已被证明是显微镜测量中真正无反应测试位置的区域的特征。结果：在OCT b扫描中，60%的完全性RPE和外视网膜萎缩（cRORA）病变（基于超透射和RPE异常≥250 μm宽度的存在，并伴有上覆光感受器（PR）变性的证据）具有可重复的≤10 dB缺陷。然而，根据所考虑的标准，92%至98%的超透射和完全RPE损失≥500 μm的病变，以及任何大小或任何特征的上覆PR变性的证据，具有可重复的≤10 dB缺陷。在超透射≥500 μm且覆盖外限制膜破裂、外丛状层和内核层下沉和/或低反射楔形带≥500 μm的病变中，有或没有RPE异常，92%至95%的病变具有可重复的≤10 dB缺陷。本研究确定了oct定义的萎缩性AMD病变的各种标准，这些病变具有高密度靶向显微镜检查中真正无反应测试位置的功能特征（即具有≥90%的可重复≤10 dB缺陷的患病率）。因此，oct定义的病变可以作为终末期萎缩性AMD的功能相关临床终点，以促进预防性治疗试验。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊