A recent systematic review and meta-analysis identified the six most relevant optical coherence tomography (OCT) prognostic biomarkers for clinicians and researchers to focus on for age-related macular degeneration (AMD) with greater predictive ability than large drusen alone.
The researchers identified a total of 114 quantified OCT prognostic biomarkers and evaluated which ones best predict the risk of progression from early/intermediate to late AMD. PubMed and Embase searches were conducted until March 2, 2023. Eligible studies were assessed using the Grade of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The primary outcome was any quantified risk of progression from treatment-naïve early/intermediate AMD to late AMD, including hazard ratios, odds ratios, and standardized mean differences (at baseline, between eyes with vs without progression), sub-grouped by each OCT biomarker. Additional meta-analyses were sub-grouped by progression to geographic atrophy or neovascularization.
The greatest magnitudes of prediction to late AMD were found using 6 biomarkers: external limiting membrane abnormality, ellipsoid zone abnormality, interdigitation zone abnormality, concurrent large drusen and reticular pseudodrusen, hypo-reflective drusen cores, intra-retinal hyper-reflective foci (IHRF), and large drusen. There was a greater risk of geographic atrophy for IHRF and hypo-reflective drusen cores, and neovascularization for ellipsoid zone abnormality. Other OCT biomarkers, including drusenoid pigment epithelium detachment, shallow irregular retinal pigment epithelium elevations, and nascent geographic atrophy, exhibited large magnitudes of risk. However, the researchers noted that further study is required to validate other biomarkers with less than high certainty of evidence, and to assess how the co-presence of biomarkers may affect risks.
Reference:
Trinh M, Cheung MR, Duong MA, Nivison-Smith L, Ly A. OCT prognostic biomarkers for progression to late age-related macular degeneration: A systematic review and meta-analysis. Ophthalmol Retina. 2023 Dec 26:S2468-6530(23)00668-1. doi:10.1016/j.oret.2023.1
This content is independent editorial sponsored by Astellas. Astellas had no input in the development of this content.
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