Biomarkers Foretell AMD Progression to Exudative Macular Neovascularization

A thick double layer sign (DLS), intraretinal hyperreflective foci (IHRF), and fellow eye exudative macular neovascularization (MNV) may indicate an increased risk of progression from intermediate age-related macular degeneration (AMD) to MVN, according to research published in the American Journal of Ophthalmology. 

Researchers included 458 patients with AMD (eyes, 458; mean age, 74.4 years; 63.5% women) in a retrospective cohort study to investigate prognostic factors for MNV progression. All participants underwent a baseline optical coherence tomography (OCT) assessment and received a follow-up scan a mean 24 months following the initial assessment.   

A total of 83 eyes (18.1%) progressed to MVN during the 2-year study period. The research team identified thick DLS (odds ratio [OR], 4.339; 95% CI, 2.178-8.644; P <.001), IHRF (OR, 2.340; 95% CI, 1.396-3.922; P =.001), and fellow eye exudative MNV (OR, 1.694; 95% CI, 1.012-2.837; P =.045) as variables independently associated with MVN development within 2 years. Although DLS was the strongest predictor for MVN conversion, it was present in fewer patients at baseline (9.6%) compared with IHRF (36.0%) and fellow eye MVN (35.8%). 

“In summary, we observed that several OCT biomarkers, a thick DLS, IHRF, and fellow eye exudative MNV were independently associated with an increased risk for conversion from [intermediate] AMD to exudative AMD over 2 years,” the study authors note. “Consideration of these features may aid in prognostication for patients and facilitate the identification of patients for early intervention trials.”

Study limitations include a retrospective nature, single center design, and short study duration. 

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.