Pachychoroid disease associated with geographic atrophy and subretinal drusenoid deposits Pseudodrusen and pachychoroid

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
George J Manayath ◽  
Shishir Verghese ◽  
Venkatapathy Narendran
Keyword(s):  
Geographic Atrophy ◽  
Subretinal Drusenoid Deposits

scholarly journals Exploratory Study on Visual Acuity and Patient-Perceived Visual Function in Patients with Subretinal Drusenoid Deposits

2020 ◽  
Vol 9 (9) ◽  
pp. 2832
Author(s):  
Manjot K. Grewal ◽  
Shruti Chandra ◽  
Sarega Gurudas ◽  
Alan Bird ◽  
Glen Jeffery ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Disease Severity ◽  
Visual Function ◽  
Healthy Aging ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Function Tests ◽  
Age Related ◽  
Low Luminance ◽  
Subretinal Drusenoid Deposits

Purpose: To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no SDD (n = 17), iAMD with SDD (n = 11) and non-foveal atrophic AMD (n = 11) confirmed by two retinal imaging modalities. Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured and low luminance deficit (LLD) was calculated. Participants were also interviewed with the low luminance questionnaire (LLQ). Linear regression was used to assess function–function relations. Compared with healthy participants, BCVA and LLVA scores were significantly reduced in the atrophic AMD group (p < 0.0001 and p = 0.00016, respectively) and in patients with SDD (p = 0.028 and p = 0.045, respectively). Participants with atrophy also had reduced BCVA (p = 0.001) and LLVA (p = 0.009) compared with the iAMD no SDD group. However, there were no differences in visual function tests between healthy aging and iAMD without SDD and between iAMD with SDD and atrophic AMD groups. The LLD score did not differ between groups. BCVA and LLVA correlated well. The LLQ did not correlate with visual function tests. This study shows that LLD is not a marker of disease severity as assessed clinically. Although LLQ is a good marker for disease severity using the current AMD classification, it does not differentiate between eyes with and without SDD. Eyes with non-macular geographic atrophy and SDD had lower function than eyes with no SDD and healthy controls.

scholarly journals Subretinal Drusenoid Deposits and Photoreceptor Loss Detecting Global and Local Progression of Geographic Atrophy by SD-OCT Imaging

2020 ◽  
Vol 61 (6) ◽  
pp. 11 ◽  
Author(s):  
Gregor S. Reiter ◽  
Reinhard Told ◽  
Markus Schranz ◽  
Lukas Baumann ◽  
Georgios Mylonas ◽  
...  
Keyword(s):  
Geographic Atrophy ◽  
Local Progression ◽  
Oct Imaging ◽  
Global And Local ◽  
Subretinal Drusenoid Deposits ◽  
Sd Oct

scholarly journals Pitfalls and Complications of Epiretinal Membrane Peeling in Eyes with Comorbid Subretinal Drusenoid Deposits: A Report of Five Cases

2020 ◽  
pp. 1-4
Author(s):  
Craig Wilde ◽  
Andrew R. Ross ◽  
Craig Wilde ◽  
Heen-Choon Chen ◽  
Mary Awad ◽  
...  
Keyword(s):  
Case Series ◽  
Geographic Atrophy ◽  
Fundus Fluorescein Angiography ◽  
Epiretinal Membranes ◽  
Case Presentation ◽  
Severe Visual Loss ◽  
Contralateral Eye ◽  
Poor Outcomes ◽  
Subretinal Drusenoid Deposits ◽  
Rule Out

Background: Idiopathic epiretinal membranes (ERM) are common with potential for severe visual loss. Surgical outcomes are excellent but predominantly reported from healthy eye studies rather than those with co-morbidities. We report a series of patients with subretinal drusenoid deposits (SRDD) and comorbid ERM with post-operative complications or poor outcomes, describing potential pitfalls to avoid. Case Presentation: This is a case series illustrating the poor functional and morphological outcomes following ERM surgery in five eyes with SRDD. These eyes appear at risk of geographic atrophy (GA), choroidal neovascular membrane (CNVM) formation (pre-and post-operatively) and outer retinal atrophy (ORA), all of which can limit outcomes. Conclusion: ERM surgery in eyes with SRDD presents specific challenges. Assessment of outer retinal changes can be challenging pre-operatively, particularly with significant oedema. Identification of patients with SRDD in ERM eyes often relies on examination of the contralateral eye. Appropriate listing is paramount, with care taken to rule out pre-existing GA or CNVM through use of fundus fluorescein angiography. Patients should be given a guarded prognosis during the consenting process if the outer retina is poorly visualized.

scholarly journals A Review of Completed and Ongoing Complement Inhibitor Trials for Geographic Atrophy Secondary to Age-Related Macular Degeneration

2021 ◽  
Vol 10 (12) ◽  
pp. 2580
Author(s):  
Omar A. Halawa ◽  
Jonathan B. Lin ◽  
Joan W. Miller ◽  
Demetrios G. Vavvas
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Western World ◽  
Complement Factor ◽  
Complement Protein ◽  
Pivotal Phase ◽  
Complement Inhibition ◽  
Exudative Amd ◽  
Age Related

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness among older adults in the Western world. While therapies exist for patients with exudative AMD, there are currently no approved therapies for non-exudative AMD and its advanced form of geographic atrophy (GA). The discovery of genetic variants in complement protein loci with increased susceptibility to AMD has led to the investigation of the role of complement inhibition in AMD with a focus on GA. Here, we review completed and ongoing clinical trials evaluating the safety and efficacy of these studies. Overall, complement inhibition in GA has yielded mixed results. The inhibition of complement factor D has failed pivotal phase 3 trials. Studies of C3 and C5 inhibition meeting their primary endpoint are limited by high rates of discontinuation and withdrawal in the treatment arm and higher risks of conversion to exudative AMD. Studies evaluating other complement members (CFB, CFH, CFI and inhibitors of membrane attack complex—CD59) are ongoing and could offer other viable strategies.

Improving Interpretability in Machine Diagnosis: Detection of Geographic Atrophy in Optical Coherence Tomography Scans

2021 ◽  
pp. 100038
Author(s):  
Xiaoshuang Shi ◽  
Tiarnan D.L. Keenan ◽  
Qingyu Chen ◽  
Tharindu De Silva ◽  
Alisa T. Thavikulwat ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Geographic Atrophy ◽  
Optical Coherence

scholarly journals Assessment of patient specific information in the wild on fundus photography and optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marion R. Munk ◽  
Thomas Kurmann ◽  
Pablo Márquez-Neila ◽  
Martin S. Zinkernagel ◽  
Sebastian Wolf ◽  
...  
Keyword(s):  
Deep Learning ◽  
Cross Sections ◽  
Underlying Disease ◽  
Geographic Atrophy ◽  
Clinical Population ◽  
Fundus Photography ◽  
Peak Performance ◽  
Patient Specific ◽  
Specific Information ◽  
Fundus Images

AbstractIn this paper we analyse the performance of machine learning methods in predicting patient information such as age or sex solely from retinal imaging modalities in a heterogeneous clinical population. Our dataset consists of N = 135,667 fundus images and N = 85,536 volumetric OCT scans. Deep learning models were trained to predict the patient’s age and sex from fundus images, OCT cross sections and OCT volumes. For sex prediction, a ROC AUC of 0.80 was achieved for fundus images, 0.84 for OCT cross sections and 0.90 for OCT volumes. Age prediction mean absolute errors of 6.328 years for fundus, 5.625 years for OCT cross sections and 4.541 for OCT volumes were observed. We assess the performance of OCT scans containing different biomarkers and note a peak performance of AUC = 0.88 for OCT cross sections and 0.95 for volumes when there is no pathology on scans. Performance drops in case of drusen, fibrovascular pigment epitheliuum detachment and geographic atrophy present. We conclude that deep learning based methods are capable of classifying the patient’s sex and age from color fundus photography and OCT for a broad spectrum of patients irrespective of underlying disease or image quality. Non-random sex prediction using fundus images seems only possible if the eye fovea and optic disc are visible.

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