Ophthalmology science · 2026
Early Structure-Function Correlates in Neovascular Age-Related Macular Degeneration Using Artificial Intelligence-Derived OCT Biomarkers.
СтатьяНазвание и аннотация: Перевод в очереди
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Mares Virginia, Sacu Stefan, Frank-Publig Sophie, Eidenberger Anna, Fuchs Philipp, Coulibaly Leonard M, Baratsits Magdalena, Faustmann Georg, Gumpinger Markus, Sükei Emese, Bogunovic Hrvoje, Reiter Gregor S, Leingang Oliver, Miere Alexandra, Creuzot-Garcher Catherine, Kodjikian Laurent, Gualino Vincent, Wolff Benjamin, Scheschy Ulrike, Schmidt-Erfurth Ursula
Аннотация
PURPOSE: To correlate automated artificial intelligence-based retinal fluid quantification with ellipsoid zone (EZ) thickness and loss, macular neovascularization (MNV) type, and visual function.
DESIGN: This is a post hoc analysis of a prospective, real-world, multicenter clinical trial.
SUBJECTS: Patients with active neovascular age-related macular degeneration (nAMD) were included.
METHODS: Best-corrected visual acuity (BCVA), measured using the ETDRS chart, OCT, OCT angiography, and microperimetry, were collected by the same certified examiners. Subretinal fluid (SRF), intraretinal fluid (IRF), and pigment epithelial detachment (PED) volumes for the central 1- and 6- mm areas were calculated at baseline using the Fluid Monitor (Retinsight) on Spectralis OCT (Heidelberg Engineering). An automated algorithm segmented EZ thickness and loss detectable after fluid resolution at month 1.
MAIN OUTCOME MEASURES: Fluid volumes were associated with MNV type, EZ thickness and loss, retinal sensitivity, and BCVA using univariate and multivariate regression models and Wilcoxon rank-sum tests with bootstrapped confidence intervals. Spearman correlation was used to analyze retinal sensitivity and EZ loss.
RESULTS: Two hundred ninety eyes from 290 consecutive patients with active MNV were included in the study at baseline. Macular neovascularization type 1 was the most prevalent in this cohort. Comparing MNV types, lower amounts of IRF were found in type 1 (all P < 0.001) and lower amounts of SRF for type 3 (all P < 0.05), in the central 1- and 6-mm areas. A decreased BCVA at month 1 was associated with IRF in the central 1 mm at baseline (-6.8 letters/100 nL; P < 0.001). Intraretinal fluid and PED volumes at baseline were correlated with EZ loss at month 1 in the central 6 mm. High fluid volumes of IRF, SRF, and PED in the central 1- and 6- mm areas also correlated with decreased mean retinal sensitivity (all P < 0.01). Ellipsoid zone loss in the central 1- and 6-mm area correlated with decreased retinal sensitivity (all P < 0.01).
CONCLUSION: Retinal fluid volumes in nAMD are triggered by MNV types and correlate with photoreceptor integrity and visual function, with the impact depending on the fluid compartment. Although fluid is central to disease monitoring, a more comprehensive approach to structural-functional assessment in nAMD is of interest.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
DESIGN: This is a post hoc analysis of a prospective, real-world, multicenter clinical trial.
SUBJECTS: Patients with active neovascular age-related macular degeneration (nAMD) were included.
METHODS: Best-corrected visual acuity (BCVA), measured using the ETDRS chart, OCT, OCT angiography, and microperimetry, were collected by the same certified examiners. Subretinal fluid (SRF), intraretinal fluid (IRF), and pigment epithelial detachment (PED) volumes for the central 1- and 6- mm areas were calculated at baseline using the Fluid Monitor (Retinsight) on Spectralis OCT (Heidelberg Engineering). An automated algorithm segmented EZ thickness and loss detectable after fluid resolution at month 1.
MAIN OUTCOME MEASURES: Fluid volumes were associated with MNV type, EZ thickness and loss, retinal sensitivity, and BCVA using univariate and multivariate regression models and Wilcoxon rank-sum tests with bootstrapped confidence intervals. Spearman correlation was used to analyze retinal sensitivity and EZ loss.
RESULTS: Two hundred ninety eyes from 290 consecutive patients with active MNV were included in the study at baseline. Macular neovascularization type 1 was the most prevalent in this cohort. Comparing MNV types, lower amounts of IRF were found in type 1 (all P < 0.001) and lower amounts of SRF for type 3 (all P < 0.05), in the central 1- and 6-mm areas. A decreased BCVA at month 1 was associated with IRF in the central 1 mm at baseline (-6.8 letters/100 nL; P < 0.001). Intraretinal fluid and PED volumes at baseline were correlated with EZ loss at month 1 in the central 6 mm. High fluid volumes of IRF, SRF, and PED in the central 1- and 6- mm areas also correlated with decreased mean retinal sensitivity (all P < 0.01). Ellipsoid zone loss in the central 1- and 6-mm area correlated with decreased retinal sensitivity (all P < 0.01).
CONCLUSION: Retinal fluid volumes in nAMD are triggered by MNV types and correlate with photoreceptor integrity and visual function, with the impact depending on the fluid compartment. Although fluid is central to disease monitoring, a more comprehensive approach to structural-functional assessment in nAMD is of interest.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.