Early detection of macular neovascularization in AMD is essential to improving treatment outcomes for the patient. A new study shows that outer retinal layer (ORL) thickening can predict the onset of wet AMD and help clinicians initiate treatment when the prognosis is more favorable.

Researchers analyzed a total of 47 eyes from 47 patients (18 males). The ORL thickness was measured from the baseline to the final visit prior to exudative MNV occurrence. Sectors that developed exudation were compared to those that didn’t.

Mean ORL thickness showed a small but statistically significant increase from the baseline measure of 85.2μm to 91.0μm at the final visit. ORL thickened in areas of the retina about eight months before exudative MNV was detected. As for the sectors that did not develop exudative MNV, no significant increase in thickness was observed.

Although exudation developed at a similar rate and drusen was evenly distributed across sectors, researchers noticed that drusen affecting the center and the inferior sector could be observed in a significant number of eyes that went on to develop exudative MNV.

“If on one side this does not allow to shed light on the pathophysiology of what precedes exudative AMD, on the other side it takes into account multiple changes occurring before the exudation, making ORL thickness a good surrogate parameter to predict the time of conversion and start treatment as early as possible,” said the researchers in their paper.

The ORL thickening and increase in drusen proceeding exudation translate to opportunities to identify the condition and immediately begin treatment to increase the likelihood of a good outcome for the patient. 

Invernizzi A , Parrulli S, Monteduro D, et al. Outer retinal layer thickening predicts the onset of exudative neovascular age related macular degeneration. Am J Ophthamal. May 16, 2021. [Epub ahead of print].