High resolution Spectral Domain-OCT imaging in Geographic Atrophy associated with Age-related Macular Degeneration

¹ Dept. Ophthalmology, University of Bonn, Bonn, Germany

^* To whom correspondence should be addressed. E-mail: frank.holz{at}ukb.uni-bonn.de.

	Abstract

Purpose: To describe morphological variations in outer retinal layers in eyes with atrophic age-related macular degeneration (AMD) using high-resolution, spectral-domain optical coherence tomography (SD-OCT). Methods: SD-OCT scans were obtained with a combined confocal scanning laser ophthalmoscope (cSLO) and SD-OCT for simultaneous tomographic and topographic in vivo imaging. A total of 81 eyes of 56 patients (mean age 77.8 ± 7.4) with geographic atrophy (GA) were examined. Morphological alterations were analyzed and classified in the perilesional zone, at the junction between GA and non atrophic retina, and in the atrophic area itself. Results: In the perilesional zone, distinct morphological alterations included elevations of the outer retinal layers, thickening and spikes of the outer hyperreflective band as well as clumps at different neurosensory retinal levels. At the junction, highly variable transitions of the outer retinal layers were present with different degrees of loss of the normal hyperreflective bands. Within the actual GA, hyperreflective clumps at different retinal levels, segmented plaques of the outer band and elevations with variable reflectivity were visualized. Conclusions: SD-OCT imaging in eyes with GA reveals a wide spectrum of morphological alterations both in the surrounding retinal tissue and in the atrophic area. These alterations may reflect different disease stages or, alternatively, heterogeneity on a cellular and molecular level. Longitudinal studies using in vivo SD-OCT imaging may allow to evaluate the relevance of these phenotypic changes as potential predictive markers for the progression of disease, i.e. enlargement rates of GA over time, and may be used for monitoring of future therapeutic interventions.

Key Words: age-related macular degeneration, optical coherence tomography, retinal pigment epithelium, scanning laser ophthalmoscopy

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