PMID- 28847641 OWN - NLM STAT- MEDLINE DCOM- 20171127 LR - 20240327 IS - 1549-4713 (Electronic) IS - 0161-6420 (Print) IS - 0161-6420 (Linking) VI - 124 IP - 12 DP - 2017 Dec TI - Optical Coherence Tomography Predictors of Risk for Progression to Non-Neovascular Atrophic Age-Related Macular Degeneration. PG - 1764-1777 LID - S0161-6420(16)32460-5 [pii] LID - 10.1016/j.ophtha.2017.06.032 [doi] AB - PURPOSE: Appearance of geographic atrophy (GA) on color photography (CP) is preceded by specific features on spectral-domain optical coherence tomography (SD OCT). We aimed to build SD OCT-based risk assessment models for 5-year new onset of GA and central GA on CP. DESIGN: Prospective, longitudinal study. PARTICIPANTS: Age-Related Eye Disease Study 2 Ancillary SD OCT study participants with age-related macular degeneration (AMD) with bilateral large drusen or noncentral GA and at least 1 eye without advanced disease (n = 317). METHODS: For 1 eye per participant, qualitative and quantitative SD OCT variables were derived from standardized grading and semiautomated segmentation, respectively, at baseline. Up to 7 years later, annual outcomes were extracted and analyzed to fit multivariate logistic regression models and build a risk calculator. MAIN OUTCOME MEASURES: New onset of CP-visible GA and central GA. RESULTS: Over a follow-up median of 4.0 years and among 292 AMD eyes (without advanced disease at baseline) with complete outcome data, 46 (15.8%) developed central GA. Among 265 eyes without any GA on baseline CP, 70 (26.4%) developed CP-visible GA. Final multivariate models were adjusted for age. In the model for GA, the independent predicting SD OCT factors (P < 0.001-0.03) were: hyperreflective foci and retinal pigment epithelium (RPE) layer atrophy or absence, followed by choroid thickness in absence of subretinal drusenoid deposits, photoreceptor outer segment loss, RPE drusen complex volume, and RPE drusen complex abnormal thinning volume. For central GA, the factors (P < 0.001) were RPE drusen complex abnormal thinning volume, intraretinal fluid or cystoid spaces, hyperreflective foci, and RPE layer atrophy or absence. The models yielded a calculator that computes the probabilities of CP-visible, new-onset GA and central GA after 1 to 5 years. CONCLUSIONS: For AMD eyes with large drusen and no advanced disease, we built a novel risk assessment model-based on age and SD OCT segmentation, drusen characteristics, and retinal pathology-for progression to CP-visible GA over up to 5 years. This calculator may simplify SD OCT grading and with future validation has a promising role as a clinical prognostic tool. CI - Copyright (c) 2017 American Academy of Ophthalmology. All rights reserved. FAU - Sleiman, Karim AU - Sleiman K AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. FAU - Veerappan, Malini AU - Veerappan M AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. FAU - Winter, Katrina P AU - Winter KP AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. FAU - McCall, Michelle N AU - McCall MN AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. FAU - Yiu, Glenn AU - Yiu G AD - Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California. FAU - Farsiu, Sina AU - Farsiu S AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina. FAU - Chew, Emily Y AU - Chew EY AD - National Eye Institute, National Institutes of Health, Bethesda, Maryland. FAU - Clemons, Traci AU - Clemons T AD - The Emmes Corporation, Rockville, Maryland. FAU - Toth, Cynthia A AU - Toth CA AD - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina. Electronic address: cynthia.toth@dm.duke.edu. CN - Age-Related Eye Disease Study 2 Ancillary Spectral Domain Optical Coherence Tomography Study Group LA - eng SI - ClinicalTrials.gov/NCT00734487 GR - P30 EY005722/EY/NEI NIH HHS/United States GR - K08 EY026101/EY/NEI NIH HHS/United States GR - R01 EY022691/EY/NEI NIH HHS/United States GR - R01 EY023039/EY/NEI NIH HHS/United States GR - R01 EY025009/EY/NEI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20170826 PL - United States TA - Ophthalmology JT - Ophthalmology JID - 7802443 SB - IM MH - Aged MH - Aged, 80 and over MH - Atrophy MH - Disease Progression MH - Female MH - Fluorescein Angiography MH - Follow-Up Studies MH - Geographic Atrophy/*diagnosis MH - Humans MH - Male MH - Middle Aged MH - Photography/methods MH - Prognosis MH - Prospective Studies MH - Retinal Drusen/*diagnosis MH - Retinal Pigment Epithelium/*pathology MH - Risk Assessment MH - Tomography, Optical Coherence/*methods PMC - PMC5768932 MID - NIHMS890719 FIR - Toth, Cynthia A IR - Toth CA FIR - Wong, Wai IR - Wong W FIR - Huang, Thomas IR - Huang T FIR - Hubbard, G Baker IR - Hubbard GB FIR - Srivastava, Sunil IR - Srivastava S FIR - McCall, Michelle IR - McCall M FIR - Winter, Katrina IR - Winter K FIR - Sarin, Neeru IR - Sarin N FIR - Hall, Katherine IR - Hall K FIR - McCollum, Patti IR - McCollum P FIR - Curtis, Linda IR - Curtis L FIR - Schuman, Stefanie IR - Schuman S FIR - Chiu, Stephanie J IR - Chiu SJ FIR - Farsiu, Sina IR - Farsiu S FIR - Tai, Vincent IR - Tai V FIR - Clemons, Traci IR - Clemons T FIR - Chew, Emily IR - Chew E EDAT- 2017/08/30 06:00 MHDA- 2017/11/29 06:00 PMCR- 2018/12/01 CRDT- 2017/08/30 06:00 PHST- 2016/12/23 00:00 [received] PHST- 2017/03/03 00:00 [revised] PHST- 2017/06/30 00:00 [accepted] PHST- 2017/08/30 06:00 [pubmed] PHST- 2017/11/29 06:00 [medline] PHST- 2017/08/30 06:00 [entrez] PHST- 2018/12/01 00:00 [pmc-release] AID - S0161-6420(16)32460-5 [pii] AID - 10.1016/j.ophtha.2017.06.032 [doi] PST - ppublish SO - Ophthalmology. 2017 Dec;124(12):1764-1777. doi: 10.1016/j.ophtha.2017.06.032. Epub 2017 Aug 26.