TY - JOUR
T1 - Characteristics and Spatial Distribution of Structural Features in Age-Related Macular Degeneration
T2 - A MACUSTAR Study Report
AU - Sa?mannshausen, Marlene
AU - Behning, Charlotte
AU - Weinz, Jonas
AU - Goerdt, Lukas
AU - Terheyden, Jan H.
AU - Chang, Petrus
AU - Schmid, Matthias
AU - Poor, Stephen H.
AU - Zakaria, Nadia
AU - Finger, Robert P.
AU - Holz, Frank G.
AU - Pfau, Maximilian
AU - Schmitz-Valckenberg, Steffen
AU - Thiele, Sarah
AU - MACUSTAR consortium members
AU - Agostini, H.
AU - Altay, L.
AU - Atia, R.
AU - Bandello, F.
AU - Basile, P. G.
AU - Behning, C.
AU - Belmouhand, M.
AU - Berger, M.
AU - Binns, A.
AU - Boon, C. J. F.
AU - B?ttger, M.
AU - Bouchet, C.
AU - Brazier, J. E.
AU - Butt, T.
AU - Carapezzi, C.
AU - Carlton, J.
AU - Carneiro, A.
AU - Charil, A.
AU - Coimbra, R.
AU - Cozzi, M.
AU - Crabb, D. P.
AU - Cunha-Vaz, J.
AU - Dahlke, C.
AU - de Sisternes, L.
AU - Dunbar, H.
AU - Finger, R. P.
AU - Fletcher, E.
AU - Floyd, H.
AU - Francisco, C.
AU - Gutfleisch, M.
AU - Hogg, R.
AU - Holz, F. G.
AU - Hoyng, C. B.
AU - Kilani, A.
AU - Kr?tzschmar, J.
AU - K?hlewein, L.
N1 - Funding Information: S.T.: Grant – German Research Foundation (grant no.: DFG, TH 2514/2-1), Maria-von-Linden Program, University of Bonn, Bonfor Research Grant, Dr. Werner Jackstädt Nachwuchspreis of the German Retina Society, Young researcher grant (Anschubfinanzierung) provided by the German Society of Ophthalmology (DOG); Payment – Heidelberg Engineering, Novartis, Bayer, Allergan; Participation – Novartis; Other financial or non-financial interests – Heidelberg Engineering; Optos, Zeiss, CenterVue. Funding Information: M.S.: Grant – BONFOR GEROK Program, Faculty of Medicine, University of Bonn (grant no.: O-137.0030), Anna-Katharina Eichenauer Foundation; Funding – Heidelberg Engineering, CenterVue, Carl Zeiss MedicTec. Publisher Copyright: © 2022 American Academy of Ophthalmology
PY - 2023/5
Y1 - 2023/5
N2 - Purpose: To report the prevalence and topographic distribution of structural characteristics in study participants with age-related macular degeneration (AMD) and controls in the cross-sectional study part of the MACUSTAR study (ClinicalTrials.gov Identifier: NCT03349801). Design: European, multicenter cohort study. Subjects: Overall, 301 eyes of 301 subjects with early (n = 34), intermediate (n = 168), and late AMD (n = 43), as well as eyes without any AMD features (n = 56). Methods: In study eyes with intermediate AMD (iAMD), the presence of structural AMD biomarkers, including pigmentary abnormalities (PAs), pigment epithelium detachment (PED), refractile deposits, reticular pseudodrusen (RPD), hyperreflective foci (HRF), incomplete/complete retinal pigment epithelium (RPE), and outer retinal atrophy (i/cRORA), and quiescent choroidal neovascularization (qCNV) was systematically determined in the prospectively acquired multimodal retinal imaging cross-sectional data set of MACUSTAR. Retinal layer thicknesses and the RPE drusen complex (RPEDC) volume were determined for the total study cohort in spectral-domain (SD) OCT imaging using a deep-learning?based algorithm. Main Outcome Measures: Prevalence and topographic distribution of structural iAMD features. Results: A total of 301 study eyes of 301 subjects with a mean (? standard deviation) age of 71.2 ? 7.20 years (63.1% women) were included. Besides large drusen, the most prevalent structural feature in iAMD study eyes were PA (57.1%), followed by HRF (51.8%) and RPD (22.0%). Pigment epithelium detachment lesions were observed in 4.8%, vitelliform lesions in 4.2%, refractile deposits in 3.0%, and qCNV in 2.4%. Direct precursor lesions for manifest retinal atrophy were detected in 10.7% (iRORA) and 4.2% (cRORA) in iAMD eyes. Overall, the highest RPEDC volume with a median of 98.92 ? 10?4 mm? was found in iAMD study eyes. Spatial analysis demonstrated a predominant distribution of RPD in the superior and temporal subfields at a foveal eccentricity of 1.5 to 2 mm, whereas HRF and large drusen had a distinct topographic distribution involving the foveal center. Conclusions: Detailed knowledge of the prevalence and distribution of structural iAMD biomarkers is vital to identify reliable outcome measure for disease progression. Longitudinal analyses are needed to evaluate their prognostic value for conversion to advanced disease stages. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
AB - Purpose: To report the prevalence and topographic distribution of structural characteristics in study participants with age-related macular degeneration (AMD) and controls in the cross-sectional study part of the MACUSTAR study (ClinicalTrials.gov Identifier: NCT03349801). Design: European, multicenter cohort study. Subjects: Overall, 301 eyes of 301 subjects with early (n = 34), intermediate (n = 168), and late AMD (n = 43), as well as eyes without any AMD features (n = 56). Methods: In study eyes with intermediate AMD (iAMD), the presence of structural AMD biomarkers, including pigmentary abnormalities (PAs), pigment epithelium detachment (PED), refractile deposits, reticular pseudodrusen (RPD), hyperreflective foci (HRF), incomplete/complete retinal pigment epithelium (RPE), and outer retinal atrophy (i/cRORA), and quiescent choroidal neovascularization (qCNV) was systematically determined in the prospectively acquired multimodal retinal imaging cross-sectional data set of MACUSTAR. Retinal layer thicknesses and the RPE drusen complex (RPEDC) volume were determined for the total study cohort in spectral-domain (SD) OCT imaging using a deep-learning?based algorithm. Main Outcome Measures: Prevalence and topographic distribution of structural iAMD features. Results: A total of 301 study eyes of 301 subjects with a mean (? standard deviation) age of 71.2 ? 7.20 years (63.1% women) were included. Besides large drusen, the most prevalent structural feature in iAMD study eyes were PA (57.1%), followed by HRF (51.8%) and RPD (22.0%). Pigment epithelium detachment lesions were observed in 4.8%, vitelliform lesions in 4.2%, refractile deposits in 3.0%, and qCNV in 2.4%. Direct precursor lesions for manifest retinal atrophy were detected in 10.7% (iRORA) and 4.2% (cRORA) in iAMD eyes. Overall, the highest RPEDC volume with a median of 98.92 ? 10?4 mm? was found in iAMD study eyes. Spatial analysis demonstrated a predominant distribution of RPD in the superior and temporal subfields at a foveal eccentricity of 1.5 to 2 mm, whereas HRF and large drusen had a distinct topographic distribution involving the foveal center. Conclusions: Detailed knowledge of the prevalence and distribution of structural iAMD biomarkers is vital to identify reliable outcome measure for disease progression. Longitudinal analyses are needed to evaluate their prognostic value for conversion to advanced disease stages. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
KW - Age-related macular degeneration
KW - Biomarker
KW - Intermediate age-related macular degeneration
KW - Phenotyping
UR - http://www.scopus.com/inward/record.url?scp=85146560660&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.oret.2022.12.007
DO - https://doi.org/10.1016/j.oret.2022.12.007
M3 - Article
C2 - 36563964
SN - 2468-6530
VL - 7
SP - 420
EP - 430
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 5
ER -