Association between Choroidal Thickness and Drusen Subtypes in Age-Related Macular Degeneration

Cheung, Chui Ming Gemmy; Gan, Alfred Tl; Yanagi, Yasuo; Wong, Tien Yin; Spaide, Richard F.

doi:10.1016/j.oret.2018.06.014

Cited by 67 publications

(68 citation statements)

References 44 publications

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“…Although, in the current study, presence of drusen was not a significant factor for the development of nAMD in the fellow eye, pachydrusen was the most prominent drusen type at baseline compared to soft drusen or SDDs. This result is consistent with previous literature showing that pachydrusen were prevalent in the typical nAMD and PCV and particularly thicker choroid is associated with pachydrusen [12,19]. In a previous study involving patients with unilateral exudative AMD at baseline, fellow eyes with pigmentary abnormalities alone were more likely to develop PCV [9].…”

Section: Discussionsupporting

confidence: 92%

Five-Year Follow-Up of Unaffected Fellow Eyes in Patients with Polypoidal Choroidal Vasculopathy

Kim

et al. 2019

Ophthalmologica

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Purpose: To evaluate the incidence and risk factors of neovascular age-related macular degeneration (nAMD) including polypoidal choroidal vasculopathy (PCV) or any type of choroidal neovascularization (CNV) in fellow eyes of unilateral PCV. Methods: This retrospective study included 48 patients with unilateral PCV. For the initial PCV diagnosis, optical coherence tomography and indocyanine green angiography were performed, and patients with and without neovascularization were compared. Results: Of 48 fellow eyes, 10 (20.8%) had drusen, 9 (18.8%) had retinal pigment epitheliopathy, 9 (18.8%) had irregular retinal pigment epithelium (RPE) elevation, 13 (27.1%) had choroidal vascular dilation, 12 (25%) had choroidal vascular hyperpermeability, and 9 (18.8%) had branching vascular network (BVN) at baseline. The development of nAMD was noted in 8 eyes (17%). The subfoveal choroidal thickness (p = 0.001), irregular RPE elevation (p < 0.001), choroidal vascular dilation (p < 0.001), choroidal vascular hyperpermeability (p < 0.001), and BVN (p < 0.001) in fellow eyes were significantly correlated with development of PCV. After multivariate analysis, BVN (p = 0.045, odds ratio = 24.66) in the fellow eye was the only significant risk factor for the development of nAMD. Conclusions: PCV or CNV developed in 17% of fellow eyes during the 5 years. Unilateral PCV with contralateral BVN requires careful monitoring for future development of PCV or CNV in fellow eyes.

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Section: Discussionsupporting

confidence: 92%

Five-Year Follow-Up of Unaffected Fellow Eyes in Patients with Polypoidal Choroidal Vasculopathy

Kim

et al. 2019

Ophthalmologica

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“…In the present study, the frequency of “type B drusen” or “type C drusen”, reported as pachydrusen, was observed in 62.8% of all patients. This is higher than the previously reported frequency 28 . The explanation may be that (1) we diagnosed the type of drusen based solely on color fundus photographs for unbiased phenotyping, and (2) the drusen outside the macular lesion that cannot be evaluated by OCT, were counted in this study.…”

Section: Discussioncontrasting

confidence: 74%

“…If it was possible to evaluate all lesions by high-resolution OCT images, we could extract genuine drusen, the rate of which might be lower than the current result. Still, we successfully showed that the “type B drusen” or “type C drusen” are associated with pachychoroid spectrum as reported in the original article 28 , 64 . The current clustering method also demonstrated that soft drusen (Type A drusen) and pseudodrusen are rare in patients with PNV, as previously reported, suggesting that PNV is pathologically different from drusen-driven AMD.…”

Section: Discussionmentioning

confidence: 67%

“…Large soft drusen (≥ 125 µm) are known as a risk factor for late AMD 61 – 63 . While patients with PNV have been reported to have less soft drusen and less pseudodrusen 28 , 39 , a recent report has suggested another subtype of drusen called “ pachydrusen” which is associated with thickened choroid and PNV 38 . In the present study, the frequency of “type B drusen” or “type C drusen”, reported as pachydrusen, was observed in 62.8% of all patients.…”

Section: Discussionmentioning

confidence: 99%

“…For example, PCV is more prevalent in the Asian than in the Caucasian population (23–49% in Asian vs 8–9% in Caucasian) 14 – 19 , while RAP prevalence shows the opposite pattern (5–11% in Asian vs 15–20% in Caucasian) 20 – 26 . Typically, soft confluent drusen and pseudodrusen are less observed in Asian AMD individuals 27 , 28 , which is in contrast to the higher prevalence of choroidal vascular hyperpermeability (CVH) and thickened choroid in these individuals 29 – 31 .…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Deep phenotype unsupervised machine learning revealed the significance of pachychoroid features in etiology and visual prognosis of age-related macular degeneration

Hosoda

Miyake

Yamashiro

et al. 2020

Sci Rep

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Unsupervised machine learning has received increased attention in clinical research because it allows researchers to identify novel and objective viewpoints for diseases with complex clinical characteristics. In this study, we applied a deep phenotyping method to classify Japanese patients with age-related macular degeneration (AMD), the leading cause of blindness in developed countries, showing high phenotypic heterogeneity. By applying unsupervised deep phenotype clustering, patients with AMD were classified into two groups. One of the groups had typical AMD features, whereas the other one showed the pachychoroid-related features that were recently identified as a potentially important factor in AMD pathogenesis. Based on these results, a scoring system for classification was established; a higher score was significantly associated with a rapid improvement in visual acuity after specific treatment. This needs to be validated in other datasets in the future. In conclusion, the current study demonstrates the usefulness of unsupervised classification and provides important knowledge for future AMD studies.

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Incidence and Risk Factors of Reticular Pseudodrusen Using Multimodal Imaging

et al. 2020

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IMPORTANCE Although retinal multimodal imaging is needed for diagnosing reticular pseudodrusen (RPD), the incidence of RPD in the general population typically has been assessed only using fundus photographs, which may underestimate their incidence.OBJECTIVES To describe the incidence of RPD using retinal color photographs, spectral-domain optical coherence tomography scans, fundus autofluorescence, and near-infrared reflectance images among individuals 77 years of age or older and to analyze the associated risk factors of RPD. DESIGN, SETTING, AND PARTICIPANTSThe ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires) Study is a cohort of French individuals 77 years of age or older. Data for this study were collected between February 22, 2011, and February 15, 2017, with a mean (SD) follow-up of 3.7 (1.0) years (range, 1.2-5.6 years). At baseline, 501 individuals were eligible to participate. Of 1002 eyes, 197 had prevalent RPD, advanced age-related macular degeneration, or ungradable images. Of the remaining 805 eyes, 333 were missing follow-up data; therefore, the statistical analyses included data from 472 eyes. Data management and statistical analyses were performed between March 15, 2017, and April 5, 2019. MAIN OUTCOMES AND MEASURESReticular pseudodrusen were considered as present if detected by at least 2 of the following imaging methods: color fundus photographs, fundus autofluorescence, near-infrared reflectance, and spectral-domain optical coherence tomography images. RESULTSOf the 472 eyes analyzed, 263 (55.7%) were from female participants, and the mean (SD) age was 81.9 (3.2) years. Forty-three eyes developed RPD, corresponding to an annual incidence rate of 2.9% (95% CI, 1.9%-4.4%) per participant and an estimated 5-year risk of 13.5%. In multivariable analysis, 4 risk factors of incident RPD were identified: subfoveal choroidal thinning (hazard ratio [HR], 0.99; 95% CI, 0.99-1.00 per 10-μm decrease in thickness; P = .02) and the presence of the minor allelic variants rs10490924 for ARMS2 (HR, 3.57; 95% CI, 1.80-7.10; P < .001), rs1061170 for CFH (HR, 2.12; 95% CI, 1.02-4.41; P = .04), and rs10468017 for LIPC (HR, 2.57; 95% CI, 1.37-4.82; P = .003). Lipophilic statin therapy was associated with a lower incidence of RPD (HR, 0.13; 95% CI, 0.02-0.74; P = .02). CONCLUSIONS AND RELEVANCEWith the use of multimodal imaging, the RPD incidence rate was higher than previously reported in other population-based studies using fundus color images. Individuals with subfoveal choroidal thinning or carrying minor allelic variants for ARMS2, CFH, or LIPC had an increased risk for RPD, whereas lipophilic statin therapy was associated with a lower incidence.

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Association between Choroidal Thickness and Drusen Subtypes in Age-Related Macular Degeneration

Cited by 67 publications

References 44 publications

Five-Year Follow-Up of Unaffected Fellow Eyes in Patients with Polypoidal Choroidal Vasculopathy

Five-Year Follow-Up of Unaffected Fellow Eyes in Patients with Polypoidal Choroidal Vasculopathy

Deep phenotype unsupervised machine learning revealed the significance of pachychoroid features in etiology and visual prognosis of age-related macular degeneration

Incidence and Risk Factors of Reticular Pseudodrusen Using Multimodal Imaging

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