Relationship between hypertransmission defect size and progression in eyes with intermediate age-related macular degeneration

Onnisa Nanegrungsunk; Giulia Corradetti; Phichayut Phinyo; Janejit Choovuthayakorn; Srinivas R Sadda

doi:10.1038/s41433-024-03338-0

Relationship between hypertransmission defect size and progression in eyes with intermediate age-related macular degeneration

Eye (Lond). 2024 Sep 15. doi: 10.1038/s41433-024-03338-0. Online ahead of print.

Authors

Onnisa Nanegrungsunk^{1

2

3}, Giulia Corradetti^{1

2}, Phichayut Phinyo⁴, Janejit Choovuthayakorn³, Srinivas R Sadda^{5

6}

Affiliations

¹ Doheny Imaging Reading Center and Doheny Eye Institute, Pasadena, CA, USA.
² Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
³ Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁴ Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁵ Doheny Imaging Reading Center and Doheny Eye Institute, Pasadena, CA, USA. [email protected].
⁶ Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. [email protected].

PMID: 39279009
DOI: 10.1038/s41433-024-03338-0

Abstract

Objectives: To determine the associations between the presence of various-sized hypertransmission defects (hyperTDs) and progression to incomplete retinal pigment epithelial (RPE) and outer retinal atrophy (iRORA) and complete RORA (cRORA) in eyes with intermediate age-related macular degeneration (iAMD).

Methods: Optical coherence tomography (OCT) data from consecutive iAMD patients, were retrospectively reviewed. All of iAMD eyes with or without iRORA (but not cRORA) at baseline were included. Graders evaluated the presence of hyperTDs at baseline (small: 63-124 µm; medium: 125-249 µm; large: ≥ 250 µm in diameter on choroidal en face OCT) and the progression two years later.

Results: Of the 145 eyes that not developed neovascular AMD at two years, the eyes that progressed to or developed iRORA or cRORA included 13 eyes (10.7%), 5 eyes (83.3%), 9 eyes (81.8%), and 6 eyes (85.7%) in the groups with no, small, medium, and large hyperTDs at baseline, respectively (P-value < 0.001). The odds ratios (95% CI) for progression were 41.6 (4.5-383.6), 37.4 (7.3-192.0), and 49.9 (5.6-447.1) in the small, medium, and large hyperTDs groups, compared to no hyperTDs (P-value ≤ 0.001). Eyes with ≥ 2 hyperTDs also showed more frequent progression than eyes with one or no hyperTDs (100% vs. 16.4%; P-value < 0.001).

Conclusions: While most iAMD eyes with no hyperTDs remained stable on OCT over two years, eyes with hyperTDs of any size appeared to be at a higher risk for progression. HyperTDs may provide an important OCT biomarker for identifying high-risk iAMD patients.