Ultrahigh Resolution OCT Markers of Normal Aging and Early Age-related Macular Degeneration

Ophthalmology Science · 13 authors, 4 centres

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TL;DR

This prospective cross-sectional study used ultrahigh resolution spectral domain OCT to image 53 early AMD eyes and 63 normal eyes. Both qualitative and quantitative measurements showed significantly elevated visibility and thickness of the RPE-BL-BrM split/hyporeflective band in early AMD eyes compared to age-matched controls.

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Three trained readers evaluated outer retinal morphological features, and a semi-automatic segmentation algorithm quantified the RPE-BL-BrM split/hyporeflective band. Both qualitative and quantitative measurements demonstrated significantly elevated visibility and thickness of the hyporeflective band in early AMD compared to age-matched controls, whereas visibility decreases with normal aging. These findings suggest UHR SD-OCT can detect BLamD in earlier disease stages, potentially facilitating in vivo investigation of AMD pathogenesis and serving as a marker for drug development.

STUDY TYPE

cross-sectional

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ophthalmology

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ORIGINAL PAPER

PMC10034509

Ultrahigh Resolution OCT Markers of Normal Aging and Early Age-related Macular Degeneration

Ophthalmology Science

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ABSTRACT

Purpose Ultrahigh resolution spectral domain-OCT (UHR SD-OCT) enables in vivo visualization of micrometric structural markers which differentially associate with normal aging versus age-related macular degeneration (AMD). This study explores the hypothesis that UHR SD-OCT can detect and quantify sub-retinal pigment epithelium (RPE) deposits in early AMD, separating AMD pathology from normal aging. Design Prospective cross-sectional study. Participants A total of 53 nonexudative (dry) AMD eyes from 39 patients, and 63 normal eyes from 39 subjects. Methods Clinical UHR SD-OCT scans were performed using a high-density protocol. Exemplary high-resolution histology and transmission electron microscopy images were obtained from archive donor eyes. Three trained readers evaluated and labeled outer retina morphological features, including the appearance of a hyporeflective split within the RPE–RPE basal lamina (RPE-BL)–Bruch’s membrane (BrM) complex on UHR brightness (B)-scans. A semi-automatic segmentation algorithm measured the thickness of the RPE-BL-BrM split/hyporeflective band. Main Outcome Measures Qualitative description of outer retinal morphological changes on UHR SD-OCT B-scans; the proportion of the RPE-BL-BrM complex with visible split (%) and the thickness of the resulting hyporeflective band (μm). Results In young normal eyes, UHR SD-OCT consistently revealed an RPE-BL-BrM split/hyporeflective band. Its visibility and thickness were less in eyes of advanced age. However, the split/hyporeflective band was again visible in early AMD eyes. Both qualitative reading and quantitative thickness measurements showed significantly elevated visibility and thickness of the RPE-BL-BrM split/hyporeflective in early AMD eyes compared to age-matched controls. Conclusions Our imaging results strongly support the hypothesis that appearance of the RPE-BL-BrM split/hyporeflective band in older subjects is dominated by the BL deposit, an indicator of early AMD well known from histology. Ultrahigh resolution SD-OCT can be used to investigate physiological aging as well as early AMD pathology in clinical imaging studies. Developing quantifiable markers associated with disease pathogenesis and progression can facilitate drug discovery, as well as reduce clinical trial times. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

CITATION EXPORT

Siyu Chen, Omar Abu-Qamar, Deepayan Kar et al.. Ultrahigh Resolution OCT Markers of Normal Aging and Early Age-related Macular Degeneration. Ophthalmology Science. (2023). https://doi.org/10.1016/j.xops.2023.100277

AUTHORS

13 · 4 CENTRES

Siyu Chen, Omar Abu-Qamar, Deepayan Kar, Jeffrey D. Messinger, Yunchan Hwang, Eric M. Moult, Junhong Lin, Caroline R. Baumal, Andre Witkin, Michelle C. Liang, Nadia K. Waheed, Christine A. Curcio, James G. Fujimoto

1Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
2New England Eye Center, School of Medicine, Tufts University, Boston, Massachusetts
3Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
4Health Sciences and Technology, Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts