Heckenlaible Nicolas J, Toomey Christopher B, Handa James T
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Shiley Eye Institute, University of California San Diego School of Medicine, San Diego, California.
Ophthalmol Sci. 2024 Sep 5;5(1):100615. doi: 10.1016/j.xops.2024.100615. eCollection 2025 Jan-Feb.
Automated retinal cell layer segmentation empowers OCT as a precise tool for characterizing morphologic features of retinal health throughout age-related macular degeneration (AMD) progression, particularly in advance of more visible biomarkers such as drusen and macular pigmentary changes. Few studies have examined OCT changes in eyes progressing from early to intermediate disease, or combined examinations of cell layer thickness, reflectivity, and heterogeneity. Therefore, this study analyzed OCTs from eyes progressing from early to intermediate AMD to identify changes in retinal morphology and reflectivity that may serve as biomarkers of early progression.
Retrospective cohort study.
Patients ≥50 years with a diagnosis of AMD and with high-quality ipsilateral OCTs in both early and intermediate stage disease.
Fifty OCTs from 25 patients were automatically segmented using a previously validated artificial intelligence-driven algorithm. Changes in the mean and standard deviation of cell layer thickness and reflectivity with progression through stages were calculated for 90 retinal volumes with the help of a novel Python-based analysis tool.
The primary outcomes were significant changes to cell layer thickness, reflectivity, and heterogeneity with progression of AMD.
With progression from early to intermediate disease, photoreceptor outer segments diffusely thinned. Within the ellipsoid zone, the fovea and parafovea were thinned with a simultaneous increase in thickness variability and a decrease in parafoveal reflectivity. The retinal pigment epithelium-Bruch's membrane complex underwent diffuse thickening and increased thickness variability alongside a decrease in foveal and parafoveal reflectivity.
These findings correlate with the known histopathology of early AMD and identify measurable OCT trends through the earliest stages of disease.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
视网膜细胞层自动分割技术使光学相干断层扫描（OCT）成为一种精确工具，可用于在年龄相关性黄斑变性（AMD）进展过程中表征视网膜健康的形态学特征，特别是在诸如玻璃膜疣和黄斑色素变化等更明显的生物标志物出现之前。很少有研究考察从早期到中期疾病进展过程中眼睛的OCT变化，或者对细胞层厚度、反射率和异质性进行联合检查。因此，本研究分析了从早期AMD进展到中期AMD的眼睛的OCT，以确定可能作为早期进展生物标志物的视网膜形态和反射率变化。
回顾性队列研究。
年龄≥50岁、诊断为AMD且在疾病早期和中期均有高质量同侧OCT的患者。
使用先前验证的人工智能驱动算法对来自25名患者的50张OCT进行自动分割。借助一种基于Python的新型分析工具，计算90个视网膜体积在不同阶段进展过程中细胞层厚度和反射率的均值和标准差变化。
主要结局是随着AMD进展，细胞层厚度、反射率和异质性的显著变化。
随着疾病从早期进展到中期，光感受器外节弥漫性变薄。在椭圆体带内，中央凹和旁中央凹变薄，同时厚度变异性增加，旁中央凹反射率降低。视网膜色素上皮-布鲁赫膜复合体弥漫性增厚，厚度变异性增加，同时中央凹和旁中央凹反射率降低。
这些发现与早期AMD已知的组织病理学相关，并确定了疾病最早阶段可测量的OCT趋势。
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
