title: Vitreoretinal interface changes in geographic atrophy.
abstract: OBJECTIVE
  Geographic atrophy (GA) is the end-stage manifestation of atrophic age-related macular degeneration (AMD). The disease progresses slowly over time, eventually causing loss of central vision. Its cause and pathomechanism are not fully known. Previous studies have suggested that vitreoretinal traction (VRT) may contribute to the progression of neovascular AMD. The aim of this study was to examine whether an association between changes at the vitreoretinal interface (VRI), in particular traction (VRT), and the characteristics and progression of GA in eyes with dry AMD can be established.
  
  
  METHODS
  Clinic-based prospective cohort study.
  
  
  METHODS
  A total of 97 patients (age range, 61-90 years; mean, 78.4 years) with GA secondary to dry AMD were enrolled. Patients exhibiting neovascular signs on fluorescein angiography in either eye were excluded.
  
  
  METHODS
  The VRI changes were examined using spectral-domain optical coherence tomography (SD-OCT). Characteristics of GA were examined using fundus autofluorescence (FAF) imaging. All imaging was performed using a Spectralis SLO+OCT device (Heidelberg Engineering, Heidelberg, Germany); GA area was measured using the Region Finder (Heidelberg Engineering) software native to the Spectralis platform.
  
  
  METHODS
  Area and increase in area of GA.
  
  
  RESULTS
  A total of 97 eyes were examined. Vitreoretinal traction was found in 39 eyes (40%). The GA area at baseline was 6.65±5.64 mm(2) in eyes with VRT and 5.73±4.72 mm(2) in eyes with no VRT. The annual rate of progression of GA area progression was 2.99±0.66 mm(2) in eyes with VRT and 1.45±0.67mm(2) in eyes without VRT. Differences between groups in both parameters were statistically significant (n = 97 total number of eyes; P<0.001). Multiple regression analysis confirmed this finding (B = 0.714, P<0.001; F3,93 = 72.542, P<0.001; adjusted R(2) = 0.691) CONCLUSIONS: Our results indicate an association between VRT and an increased rate of progression of GA area in dry AMD. Monitoring VRT may contribute to an improved estimate of the prospective time of visual loss and to a better timing of emerging therapies in dry AMD.
authors.affiliation: Bern Photographic Reading Center, Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland.
authors.forename: Hannan
authors.initials: H
authors.lastname: Abdillahi
authors.affiliation: Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland.
authors.forename: Volker
authors.initials: V
authors.lastname: Enzmann
authors.affiliation: Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland.
authors.forename: Valéry V
authors.initials: VV
authors.lastname: Wittwer
authors.affiliation: Bern Photographic Reading Center, Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland; Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wolf
authors.affiliation: Bern Photographic Reading Center, Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland; Department of Ophthalmology, University Hospital, Inselspital and University of Bern, Bern, Switzerland. Electronic address: ute.wolf@insel.ch.
authors.forename: Ute E K
authors.initials: UE
authors.lastname: Wolf-Schnurrbusch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D015352:Dry Eye Syndromes / Q000150:complications*; D005260:Female; D057092:Geographic Atrophy / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D041623:Tomography, Optical Coherence; D014792:Visual Acuity