Conversion from Intermediate Age-Related Macular Degeneration to Geographic Atrophy in a Proxima B Subcohort Using a Multimodal Approach

Introduction: This retrospective analysis assessed geographic atrophy (GA) progression in fellow eyes from the Proxima B trial intermediate age-related macular degeneration (iAMD) subcohort using high-resolution multimodal imaging anchored on optical coherence tomography (OCT). Methods: Thirty-two patients from the Proxima B iAMD subcohort were assessed; all had GA with no macular neovascularization (MNV) in the contralateral eye. Imaging data, including color fundus photography, fluorescein angiography, near-infrared reflectance, fundus autofluorescence (FAF), and spectral-domain OCT, were obtained. Features preceding progression/conversion to advanced AMD (drusen, reticular pseudodrusen [RPD], MNV, incomplete/complete retinal pigment epithelium and outer retinal atrophy [iRORA/cRORA]) were assessed. Results: Of 30 fellow eyes with available follow-up images, 12 converted to GA (FAF), 2 converted to MNV, and 16 were nonconverters during the review period (median: 17.8 months). iRORA/cRORA features (present in all converters at baseline) were identified on OCT in eyes that progressed to GA. Median time interval from iRORA to cRORA and from cRORA to GA was 7 months each. GA development/progression was either drusen- or RPD-associated (n = 6 each). Eyes with baseline RPD showed faster GA progression versus eyes with drusen (1.49 vs. 0.38 mm2/year). Conclusions: RPD presence was associated with rapid GA lesion enlargement and may provide an early indication of faster GA progression.

简介：该回顾性分析使用高分辨率的多模式成像固定在光学相干断层扫描（OCT）的高分辨率多模拟成像（OCT）中，评估了来自Proxima B试验中级与年龄相关的黄斑变性（IAMD）亚群的地理萎缩（GA）进展。方法：评估了来自Proxima biamd子病人的32名患者；所有人的GA都在对侧眼中没有黄斑新生血管形成（MNV）。获得了成像数据，包括彩色眼底摄影，荧光素血管造影，近红外反射率，眼底自动荧光（FAF）和光谱域OCT。评估了先前的进展/转化为晚期AMD（DRUSEN，网状伪drusen [RPD]，MNV，不完整/完整的视网膜色素上皮和视网膜外萎缩[IRORA/CRORA]）。结果：在30个具有可用后续图像的同伴中，有12个转换为GA（FAF），其中2个转换为MNV，在审查期间是非会员（中位数：17.8个月）。 Irora/Crora特征（基线的所有转换器中存在）在OCT的眼睛中鉴定出发展为GA的眼睛。从Irora到Crora以及从Crora到GA的中间时间间隔为7个月。 GA的发育/进展是drusen-或RPD相关的（n = 6）。基线RPD的眼睛与Drusen的眼睛相比（1.49 vs. 0.38 mm2/年）显示出更快的GA进展。结论：RPD的存在与快速的GA病变增大有关，并可能提供更快的GA进展的早期指示。