Persistent Hypertransmission Defects Detected on En Face Swept Source Optical Computed Tomography Images Predict the Formation of Geographic Atrophy in Age-Related Macular Degeneration

Laiginhas, Rita; Shi, Yingying; Shen, Mengxi; Jiang, Xiaoshuang; Feuer, William J.; Gregori, Giovanni; Rosenfeld, Philip J.

doi:10.1016/j.ajo.2021.11.001

Cited by 39 publications

(39 citation statements)

References 19 publications

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“…More recently, the Classification of Atrophy Meeting (CAM) group has recommended that atrophy in patients with either neovascular or nonneovascular AMD could be defined based on the anatomic layers affected, most readily characterized by OCT [11 ▪▪ ,12]. Incomplete RPE and outer retinal atrophy (iRORA) alongside drusen refers to a region of choroidal signal hypertransmission, a corresponding zone of attenuation or disruption of the RPE, and overlying photoreceptor degeneration [13].…”

Section: Early Detection Of Geographic Atrophymentioning

confidence: 99%

“…Assessment of iRORA and cRORA has been demonstrated as having consistent inter-reader agreement, and thus may be useful not only in clinical setting but also in interventional trials in AMD ] concurred that iRORA is a significant risk factor for progression to GA, but the association is likely driven by the development of specific features that define nascent geographic atrophy (nGA) -including subsidence of the inner nuclear layer and outer plexiform layer, or the presence of a hyporeflective wedge-shaped band within Henle's fiber layer. Persistent choroidal hypertransmission defects on OCT imaging are also strongly associated with nGA [12,18].…”

Section: Key Pointsmentioning

confidence: 99%

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Identifying geographic atrophy

Clevenger

Rachitskaya

2023

Current Opinion in Ophthalmology

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Purpose of reviewAge-related macular degeneration (AMD) is one of the leading causes of blindness and can progress to geographic atrophy (GA) in late stages of disease. This review article highlights recent literature which assists in the accurate and timely identification of GA, and monitoring of GA progression. Recent findingsTechnology for diagnosing and monitoring GA has made significant advances in recent years, particularly regarding the use of optical coherence tomography (OCT). Identification of imaging features which may herald the development of GA or its progression is critical. Deep learning applications for OCT in AMD have shown promising growth over the past several years, but more prospective studies are needed to demonstrate generalizability and clinical utility.

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Section: Early Detection Of Geographic Atrophymentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Identifying geographic atrophy

Clevenger

Rachitskaya

2023

Current Opinion in Ophthalmology

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“…This size cut‐off for describing a continuous biological process is motivated by the considerable human inter‐rater variability of atrophy‐related features (Wu et al., 2022). Importantly, RPE hypertransmission defects >250 μm were shown to be prognostic for future atrophy development (Laiginhas et al., 2022; Shi et al., 2021).…”

Section: Diagnosing and Classifying Geographic Atrophymentioning

confidence: 99%

Multimodal imaging and deep learning in geographic atrophy secondary to age‐related macular degeneration

Pfau,

Künzel,

Pfau

et al. 2023

Acta Ophthalmologica

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Geographic atrophy (GA) secondary to age‐related macular degeneration is among the most common causes of irreversible vision loss in industrialized countries. Recently, two therapies have been approved by the US FDA. However, given the nature of their treatment effect, which primarily involves a relative decrease in disease progression, discerning the individual treatment response at the individual level may not be readily apparent. Thus, clinical decision‐making may have to rely on the quantification of the slope of GA progression before and during treatment. A panel of imaging modalities and artificial intelligence (AI)‐based algorithms are available for such quantifications. This article aims to provide a comprehensive overview of the fundamentals of GA imaging, the procedures for diagnosis and classification using these images, and the cutting‐edge role of AI algorithms in automatically deriving diagnostic and prognostic insights from imaging data.

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“…Furthermore, the presence of heterogeneous internal reflectivity within drusen (ie, calcified drusen) was associated with progression to advanced AMD (neovascular AMD or GA) over 1 year [30]. In addition, the appearance of persistent hyper-transmission defects with a minimum size of 250 µm on en-face swept-source OCT scans was found to increase the risk of progression to GA [31].…”

Section: Imaging Predictors Of Disease Progressionmentioning

confidence: 99%

Future perspectives for treating patients with geographic atrophy

Loewenstein

Trivizki

2022

Graefes Arch Clin Exp Ophthalmol

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Purpose Geographic atrophy (GA) is a late-stage form of age-related macular degeneration (AMD) characterized by the expansion of atrophic lesions in the outer retina. There are currently no approved pharmacological treatments to prevent or slow the progression of GA. This review describes the progression and assessment of GA, predictive imaging features, and complement-targeting investigational drugs for GA. Methods A literature search on GA was conducted. Results Expansion of atrophic lesions in patients with GA is associated with a decline in several measures of visual function. GA lesion size has been moderately associated with measures obtained through microperimetry, whereas GA lesion size in the 1-mm diameter area centered on the fovea has been associated with visual acuity. Optical coherence tomography (OCT) can provide 3-dimensional quantitative assessment of atrophy and is useful for identifying early atrophy in GA. Features that have been found to predict the development of GA include certain drusen characteristics and pigmentary abnormalities. Specific OCT features, including hyper-reflective foci and OCT-reflective drusen substructures, have been associated with AMD disease progression. Lesion characteristics, including focality, regularity of shape, location, and perilesional fundus autofluorescence patterns, have been identified as predictors of faster GA lesion growth. Certain investigational complement-targeting drugs have shown efficacy in slowing the progression of GA. Conclusion GA is a progressive disease associated with irreversible vision loss. Therefore, the lack of treatment options presents a significant unmet need. OCT and drugs under investigation for GA are promising future tools for disease management.

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Persistent Hypertransmission Defects Detected on En Face Swept Source Optical Computed Tomography Images Predict the Formation of Geographic Atrophy in Age-Related Macular Degeneration

Cited by 39 publications

References 19 publications

Identifying geographic atrophy

Identifying geographic atrophy

Multimodal imaging and deep learning in geographic atrophy secondary to age‐related macular degeneration

Future perspectives for treating patients with geographic atrophy

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