New OCT parameters associated with wet AMD risk

Fort Lauderdale, FL-Although optical coherence tomography (OCT) is widely used in the diagnosis and management of age-related macular degeneration (AMD), closer scrutiny of these scans may reveal useful new parameters, according to Florian M. Heussen, MD.

In a retrospective review of spectral-domain OCT scans of eyes that had progressed to neovascular AMD and a control group of eyes with high-risk AMD that had not transitioned, two features were strongly associated with imminent development of choroidal neovascularization: hyperreflective foci and pigment epithelial detachments (PED) with heterogeneous internal reflectivity, said Dr. Heussen, Doheny Eye Institute, Keck School of Medicine at the University of Southern California, Los Angeles.

Scans of eyes in both the transition and control groups were randomly assigned and independently graded by two certified graders looking at parameters, such as the presence of a break in the retinal pigment epithelial (RPE) band, thickening or thinning of the RPE band, RPE band integrity, internal reflectivity of the PED (homogenous hyper or hypo or heterogeneous), retinal atrophy, epiretinal membrane, or simplified quantification of any subretinal fluid, cystoid macular edema, or intraretinal hyperreflective foci.

Only hyperreflective foci and heterogeneous PED stood out on univariate analysis, a finding that remained in the multivariate analysis, Dr. Heussen said.

Because this was a small study involving only 20 eyes each in the transitional and control groups, a large prospective study is warranted, he added.

However, until such a study can occur, he recommended closer monitoring of patients whose OCT scans show the two factors associated with transition.

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