title: Spectral-domain optical coherence tomography characteristics of intermediate age-related macular degeneration.
abstract: OBJECTIVE
  Describe qualitative spectral-domain optical coherence tomography (SD-OCT) characteristics of eyes classified as intermediate age-related macular degeneration (nonadvanced AMD) from Age-Related Eye Disease Study 2 (AREDS2) color fundus photography (CFP) grading.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  We included 345 AREDS2 participants from 4 study centers and 122 control participants who lack CFP features of intermediate AMD.
  
  
  METHODS
  Both eyes were imaged with SD-OCT and CFP. The SD-OCT macular volume scans were graded for the presence of 5 retinal, 5 subretinal, and 4 drusen characteristics. In all, 314 AREDS2 participants with ≥1 category-3 AMD eye and all controls each had 1 eye entered into SD-OCT analysis, with 63 eyes regraded to test reproducibility.
  
  
  METHODS
  We assessed SD-OCT characteristics at baseline.
  
  
  RESULTS
  In 98% of AMD eyes, SD-OCT grading of all characteristics was successful, detecting drusen in 99.7%, retinal pigment epithelium (RPE) atrophy/absence in 22.9%, subfoveal geographic atrophy in 2.5%, and fluid in or under the retina in 25.5%. Twenty-eight percent of AMD eyes had characteristics of possible advanced AMD on SD-OCT. Two percent of control eyes had drusen on SD-OCT. Vision loss was not correlated with foveal drusen alone, but with foveal drusen that were associated with other foveal pathology and with overlying focal hyperreflectivity. Focal hyperreflectivity over drusen, drusen cores, and hyper- or hyporeflectivity of drusen were also associated with RPE atrophy.
  
  
  CONCLUSIONS
  Macular pathologies in AMD can be qualitatively and reproducibly evaluated with SD-OCT, identifying pathologic features that are associated with vision loss, RPE atrophy, and even possibly the presence of advanced AMD not apparent on CFP. Qualitative and detailed SD-OCT analysis can contribute to the anatomic characterization of AMD in clinical studies of vision loss and disease progression.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: Duke Eye Center, Durham, North Carolina 27710, USA.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Leuschen
authors.forename: Stefanie G
authors.initials: SG
authors.lastname: Schuman
authors.forename: Katrina P
authors.initials: KP
authors.lastname: Winter
authors.forename: Michelle N
authors.initials: MN
authors.lastname: McCall
authors.forename: Wai T
authors.initials: WT
authors.lastname: Wong
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
authors.forename: Thomas
authors.initials: T
authors.lastname: Hwang
authors.forename: Sunil
authors.initials: S
authors.lastname: Srivastava
authors.forename: Neeru
authors.initials: N
authors.lastname: Sarin
authors.forename: Traci
authors.initials: T
authors.lastname: Clemons
authors.forename: Molly
authors.initials: M
authors.lastname: Harrington
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000145:classification*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D015593:Retinal Drusen / Q000175:diagnosis; D041623:Tomography, Optical Coherence / Q000145:classification*