Drusen Characteristics Linked With AMD Risk in Fellow Eyes

By David Douglas

May 05, 2019

NEW YORK (Reuters Health) - In patients with unilateral neovascular age-related macular degeneration (AMD), certain drusen features are associated with conversion to neovascular AMD in the fellow eye, according to a secondary analysis of data from a clinical trial.

Dr. Joelle A. Hallak of the University of Illinois at Chicago and colleagues used machine learning and explanatory model-building approaches to determine optical coherence tomography (OCT) imaging features, genetic variants, demographic, and treatment effects associated with the progression of AMD.

"Use of artificial intelligence applications in ophthalmic imaging has been increasing rapidly," they noted in their report, online April 25 in JAMA Ophthalmology.

The researchers reviewed data from the HARBOR trial on 686 fellow eyes with non-neovascular AMD at baseline and compared patients who developed neovascular AMD with those who did not. Over the course of the 24-month study, 154 (22.4%) converted to neovascular AMD.

Being female was significantly associated with conversion (hazard ratio, 1.57). Other factors ultimately associated with development of choroidal neovascularization were drusen area within 3 mm of the fovea (HR, 1.45), and mean drusen reflectivity (i.e. focal hyper-pigmentation) which carried a hazard ratio of 3.97. One genetic variant (rs61941274, ACAD10 locus) also increased the risk.

"The main clinical implication of this study," Dr. Hallak told Reuters Health in an email, "is that it may further improve the early identification of patients who are at high risk of converting to neovascular age-related macular degeneration, allowing for early intervention to prevent severe visual loss."

Dr. Maureen G. Maguire of the University of Pennsylvania, Philadelphia, author of an accompanying editorial, told Reuters Health by email, "Once patients have one eye affected with late AMD, they usually want to know the risk of developing it their second eye."

Dr. Maguire added, "The recent great advances in ocular imaging, extracting information from the images, and computational and statistical methods for using the information offers hope not only for more accurate risk prediction, but also, better understanding of why eyes progress to late AMD."

SOURCE: http://bit.ly/2PGNBAw and http://bit.ly/2PIOiJq

JAMA Ophthalmol 2019.