scholarly journals Imaging Biomarkers and Their Impact on Therapeutic Decision Making in the Management of Neovascular Age-related Macular Degeneration

2021 ◽  
Author(s):  
David T. Wong ◽  
Alan R. Berger ◽  
Serge Bourgault ◽  
John Chen ◽  
Kevin Colleaux ◽  
...  
Keyword(s):  
Decision Making ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Imaging Biomarkers ◽  
Therapeutic Decision ◽  
Age Related ◽  
Therapeutic Decision Making

Major Predictive Factors for Progression of Early to Late Age-Related Macular Degeneration

2020 ◽  
Vol 243 (6) ◽  
pp. 444-452 ◽  
Author(s):  
Vasilena Sitnilska ◽  
Eveline Kersten ◽  
Lebriz Altay ◽  
Tina Schick ◽  
Philip Enders ◽  
...  
Keyword(s):  
Prediction Model ◽  
Macular Degeneration ◽  
Area Under The Curve ◽  
Age Related Macular Degeneration ◽  
Advanced Age ◽  
Fundus Photography ◽  
Imaging Biomarkers ◽  
Nucleotide Polymorphisms ◽  
Phenotypic Profile ◽  
Age Related

<b><i>Introduction:</i></b> We present a prediction model for progression from early/intermediate to advanced age-related macular degeneration (AMD) within 5.9 years. <b><i>Objectives:</i></b> To evaluate the combined role of genetic, nongenetic, and phenotypic risk factors for conversion from early to late AMD over ≥5 years. <b><i>Methods:</i></b> Baseline phenotypic characteristics were evaluated based on color fundus photography, spectral-domain optical coherence tomography, and infrared images. Genotyping for 36 single-nucleotide polymorphisms as well as systemic lipid and complement measurements were performed. Multivariable backward logistic regression resulted in a final prediction model. <b><i>Results and Conclusions:</i></b> During a mean of 5.9 years of follow-up, 22.4% (<i>n</i> = 52) of the patients (<i>n</i> = 232) showed progression to late AMD. The multivariable prediction model included age, <i>CFH</i> variant rs1061170, pigment abnormalities, drusenoid pigment epithelial detachment (DPED), and hyperreflective foci (HRF). The model showed an area under the curve of 0.969 (95% confidence interval 0.948–0.990) and adequate calibration (Hosmer-Lemeshow test, <i>p</i> = 0.797). In addition to advanced age and carrying a <i>CFH</i> variant, pigment abnormalities, DPED, and HRF are relevant imaging biomarkers for conversion to late AMD. In clinical routine, an intensified monitoring of patients with a high-risk phenotypic profile may be suitable for the early detection of conversion to late AMD.

Quantitative SD-OCT Imaging Biomarkers as Indicators of Age-Related Macular Degeneration Progression

2014 ◽  
Vol 55 (11) ◽  
pp. 7093 ◽  
Author(s):  
Luis de Sisternes ◽  
Noah Simon ◽  
Robert Tibshirani ◽  
Theodore Leng ◽  
Daniel L. Rubin
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Imaging Biomarkers ◽  
Age Related ◽  
Oct Imaging ◽  
Sd Oct

scholarly journals Machine Learning to Analyze the Prognostic Value of Current Imaging Biomarkers in Neovascular Age-Related Macular Degeneration

2018 ◽  
Vol 2 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Ursula Schmidt-Erfurth ◽  
Hrvoje Bogunovic ◽  
Amir Sadeghipour ◽  
Thomas Schlegl ◽  
Georg Langs ◽  
...  
Keyword(s):  
Machine Learning ◽  
Macular Degeneration ◽  
Prognostic Value ◽  
Age Related Macular Degeneration ◽  
Imaging Biomarkers ◽  
Age Related

Subfoveal choroidal thickness as a prognostic factor in exudative age-related macular degeneration

2018 ◽  
Vol 103 (7) ◽  
pp. 918-921 ◽  
Author(s):  
Jaya B Kumar ◽  
Karen M Wai ◽  
Justin P Ehlers ◽  
Rishi P Singh ◽  
Aleksandra V Rachitskaya
Keyword(s):  
Prognostic Factor ◽  
Macular Degeneration ◽  
Choroidal Thickness ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Imaging Biomarkers ◽  
Exudative Amd ◽  
Subfoveal Choroidal Thickness ◽  
Age Related ◽  
The Mean

AimsTo investigate the relationship between subfoveal choroidal thickness (SFCT), visual acuity (VA), optical coherence tomography (OCT) features and total anti-vascular endothelial growth factor (VEGF) treatments to determine whether SFCT serves as a prognostic factor in age-related macular degeneration (AMD).MethodsThis is a retrospective case series of 62 consecutive treatment-naive patients with exudative AMD followed for 1 year and treated with treat-and-extend or pro re nata anti-VEGF protocols. SFCT was measured at three locations using Cirrus HD-OCT (the foveal centre and 500 um nasal and temporal to the fovea) at presentation, 3, 6 and 12 months. Demographic characteristics, OCT imaging biomarkers and VA were recorded.ResultsMean SFCT at baseline was 187 µm (range: 70–361 µm). There was a trend of decreasing SFCT at 1 year (173 µm) compared with 3 months (175 µm) and baseline (188 µm) (p=0.2). There was no correlation between baseline SFCT and presence of subretinal fluid (p=0.2), intraretinal fluid (p=0.6) or subretinal hyper-reflective material (p=0.4) at baseline. The mean number of injections at 1 year was 6.6 (range: 2–12). Increased SFCT at baseline showed statistically significant correlation with a higher number of intravitreal injections at 1 year (p=0.004). Eyes with SFCT>1 SD above the mean required 50% more injections compared with others. There was no association between SFCT on presentation with baseline and 1 year VA (p=0.7 and p=0.2).ConclusionsSFCT in naïve patients with exudative AMD may be an important prognostic tool in determining treatment burden. Patients with thicker subfoveal choroid may require increased intravitreal injections.

Distinguishing Central Serous Chorioretinopathy From Neovascular Age-Related Macular Degeneration: A Prospective Study

2020 ◽  
Vol 4 (4) ◽  
pp. 293-299
Author(s):  
Parampal S. Grewal ◽  
Steven R.J. Lapere ◽  
Christopher J. Rudnisky ◽  
Rizwan Somani ◽  
Matthew T.S. Tennant
Keyword(s):  
Decision Making ◽  
Macular Degeneration ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Age Related Macular Degeneration ◽  
Subfoveal Choroidal Thickness ◽  
Pigment Epithelial ◽  
Age Related

Purpose: This article identifies clinical features that differentiate central serous chorioretinopathy (CSR) from neovascular age-related macular degeneration (nAMD) and uses this information to develop a diagnostic tool. Methods: A prospective observational study was conducted of patients with a new diagnosis of CSR, nAMD, or indeterminate presentation. All patients underwent clinical assessment, axial length measurement, enhanced-depth imaging–optical coherence tomography, and intravenous fluorescein angiography. A final consensus diagnosis was derived following review of these factors. Results: A total of 56 eyes of 56 patients were enrolled (CSR = 34; nAMD = 22). The subfoveal choroidal thickness was greater in the CSR group (421 ± 106 µm) than the nAMD group (219 ± 91 µm, P < .001). The following odds ratio of CSR reached statistical significance: age 70 and younger (72.00, 95% CI: 11.99-432.50), subfoveal choroidal thickness greater than or equal to 300 µm (33.92, 95% CI: 4.06-283.18), dome-shaped neurosensory detachment (13.24, 95% CI: 3.22-54.45), retinal pigment epithelial changes (0.31, 95% CI: 0.10-0.97), subretinal hyperreflective material (0.11, 95% CI: 0.03-0.42), and fibrovascular pigment epithelial detachment (0.05, 95% CI: 0.01-0.47). A stepwise CSR vs nAMD clinical decision-making algorithm is proposed. Conclusions: Choroidal thickness is increased in CSR when compared with nAMD. The presented odds ratios and the CSR vs nAMD clinical decision-making tool can be applied to distinguish CSR from nAMD.

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