gms | German Medical Science

Background: To describe morphological variations in outer retinal layers in eyes with atrophic AMD using high-resolution, spectral-domain optical coherence tomography (SD-OCT).

Methods: SD-OCT scans were obtained by combined confocal scanning laser ophthalmoscopy and SD-OCT imaging. A total of 81 eyes of 56 patients (mean age 77.8 ± 7.4) with geographic atrophy (GA) were examined. Morphological alterations were analyzed in the perilesional zone, at the border of GA and in the atrophic area.

Results: In the perilesional zone, distinct morphological alterations included elevations of the outer retinal layers, thickening and spikes of the outer hyperreflective band as well as clumps at different neurosensory retinal levels. At the border of GA, highly variable transitions of the outer retinal layers were present with different degrees of loss of the normal hyperreflective bands. Within the actual GA, hyperreflective clumps at different retinal levels, segmented plaques of the outer band and elevations with variable reflectivity were visualized.

Conclusions: SD-OCT imaging in eyes with GA reveals a wide spectrum of morphological alterations both in the surrounding retinal tissue and in the atrophic area. These alterations may reflect different disease stages or, alternatively, heterogeneity on a cellular and molecular level. Longitudinal studies using in vivo SD-OCT imaging may allow to evaluate the relevance of these phenotypic changes as potential predictive markers for the progression of disease, and may be used for monitoring of future therapeutic interventions.