Researchers confirmed that four previously reported optical coherence tomography (OCT) risk factors were associated with progression to late age-related macular degeneration (AMD) in the fellow eyes of participants newly diagnosed with macular neovascularization.

This multicenter, prospective, randomized, double-masked, active treatment-controlled phase 3 clinical trial evaluated 501 eyes of 501 patients with macular neovascularization secondary to neovascular AMD and early or intermediate AMD in the fellow eye. 

The team reviewed OCT scans and assessed baseline features, including intraretinal hypereflective foci (IHRF), hyporeflective foci (hRF) within drusenoid lesions (DLs), subretinal drusenoid deposits (SDDs) and drusen volume (DV) ≥ 0.03 mm3. Masked graders assessed OCT images at six, 12, 18 and 24 months for late AMD. The team then correlated demographic characteristics (age, gender, smoke exposure) and baseline OCT features with progression to late AMD.

By month 24, the researchers found that 33.13% of eyes had developed late AMD. They note that while baseline demographic factors were not significantly associated with the development of late AMD, significant associations were identified for all OCT features. They add that the correlation remained significant when considering only the progression to complete retinal pigment epithelium and photoreceptor atrophy and macular neovascularization alone, except for DV, which was not significantly associated with progression to macular neovascularization.

The study authors conclude that although outcomes beyond two years of follow-up were not evaluated, these findings may help identify high-risk AMD patients.

Nassisi M, Lei J, Abdelfattah NS, et al. Optical coherence tomography risk factors for development of late age-related macular degeneration in the fellow eyes of patients enrolled in the HARBOR Study. Ophthalmology. May 28. 2019. [Epub ahead of print].