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Baseline Spectral Domain Optical Coherence Tomography Characteristics of Age-Related Macular Degeneration

Nittala, Muneeswar G., MPhil*; Song, Yeunjoo E., PhD; Sardell, Rebecca, PhD; Adams, Larry D., BA; Pan, Samuel, MS; Velaga, Swetha B., OD*; Horst, Violet§; Dana, Debra, BA§; Caywood, Laura, BSN-RN; Laux, Renee, MS; Fuzzell, Denise, BS; Fuzzell, Sarada, BA; Scott, William K., PhD; Cooke Bailey, Jessica N., PhD; Igo, Robert P. Jr, PhD; Haines, Jonathan, PhD†,¶; Pericak-Vance, Margaret A., PhD; Sadda, SriniVas R., MD*,§; Stambolian, Dwight, MD, PhD**

doi: 10.1097/IAE.0000000000002210
Original Study: PDF Only

Purpose: To describe spectral domain optical coherence tomography (SD-OCT) findings in an Amish cohort to assess SD-OCT markers for early age-related macular degeneration (AMD).

Methods: The authors performed a family-based prospective cohort study of 1,146 elderly Amish subjects (age range 50–99 years) (2,292 eyes) who had a family history of at least 1 individual with AMD. All subjects underwent complete ophthalmic examinations, SD-OCT using both Cirrus and Spectralis (20 × 20° scan area) instruments, fundus autofluorescence, infrared imaging, and color fundus photography. Spectral domain optical coherence tomography characteristics were analyzed in subjects with AMD (with and without subretinal drusenoid deposits [SDDs]) and normal healthy cohorts.

Results: Participants' mean age was 65.2 years (SD ± 11). Color fundus photographic findings in 596 (53%) subjects (1,009 eyes) were consistent with AMD; the remaining 478 (43%) subjects showed no signs of AMD. The choroid was significantly thinner on OCT (242 ± 76 µm, P < 0.001) in those with AMD compared with those without (263 ± 63 µm). Subretinal drusenoid deposits were found in 143 eyes (7%); 11 of the 143 eyes (8%) had no other manifestations of AMD. Drusen volume (P < 0.001) and area of geographic atrophy (P < 0.001) were significantly greater, and choroid was significantly (P < 0.001) thinner in subjects with SDDs versus those without SDDs.

Conclusion: The authors describe spectral domain optical coherence tomography characteristics in an elderly Amish population with and without AMD, including the frequency of SDD. Although relatively uncommon in this population, the authors confirmed that SDDs can be found in the absence of other features of AMD and that eyes with SDDs have thinner choroids.

This is a family-based study describing the spectral domain optical coherence tomography characteristics in an Amish population; subjects with age-related macular degeneration had thinner choroids, greater drusen volume, and more frequent subretinal drusenoid deposits.

*Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California;

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio;

John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida;

§Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California;

Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio; and

**Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.

Reprint requests: Dwight Stambolian, MD, PhD, University of Pennsylvania, Perelman School of Medicine, Room 313 Stellar Chance Labs, 422 Curie Blvd, Philadelphia, PA 19104; e-mail:

Supported by the National Eye Institute, Bethesda, Maryland (Grant #RO1 EY023164), the Department of Ophthalmology at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, John P. Hussman Institute of Human Genomics at the University Of Miami Miller School Of Medicine, Miami, Florida and the Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio. Funds also were received from the F.M. Kirby Foundation and Research to Prevent Blindness.

None of the authors has any financial/conflicting interests to disclose.

J. Haines, M. A. Pericak-Vance, S. R. Sadda, and D. Stambolian are co-authors and contributed equally to the work.

© 2019 by Ophthalmic Communications Society, Inc.