PREDICTIVE FACTORS FOR DEVELOPMENT OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Spectral-Domain Optical Coherence Tomography Study.
OBJECTIVE
To investigate the risk factors predictive for the development of neovascular age-related macular degeneration (NVAMD) by means of spectral-domain optical coherence tomography.


METHODS
Retrospective study of 73 eyes graded Stage 2 and Stage 3 according to the AMD International Grading System with minimum follow-up of 24 months. Drusenoid pigment epithelial detachment, hyperreflective foci, external limiting membrane, inner ellipsoid band, and retinal pigment epithelium integrity were analyzed at baseline and last follow-up. Binary logistic regression model analyzed significant predictors of neovascular conversion.


RESULTS
The discontinuity of external limiting membrane, inner ellipsoid band, and retinal pigment epithelium bands were significantly more prevalent in the NVAMD group at baseline and last follow-up (P < 0.001). Hyperreflective foci represented the single most important predictor of neovascular conversion (Exp [B], 15.15; P = 0.005) as confirmed by Kaplan-Meier curve (P = 0.002). Drusenoid pigment epithelial detachment width was significantly greater in NVAMD group than control subjects at baseline and last follow-up (P < 0.001), and its delta value also resulted a significant neovascular predictor (Exp [B], 0.99; P = 0.04).


CONCLUSIONS
Hyperreflective foci significantly increase the risk of NVAMD progression. The delta width of drusenoid pigment epithelial detachment also predicts disease progression, integrating the stratification of NVAMD progression risk.
Department of Medical-Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy.
Serena
S
Fragiotta
Department of Ophthalmology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
Tommaso
T
Rossi
Department of Medical-Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy.
Alessandro
A
Cutini
Department of Medical-Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy.
Pier L
PL
Grenga
Department of Medical-Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy.
Enzo M
EM
Vingolo
D000368:Aged; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D057135:Wet Macular Degeneration / Q000175:diagnosis*