Abstract

P 241

Changes of the vitreoretinal interface surveyed by high resolution spectral domain OCT in patients with geographic atrophy due to ARMD

Christian Karl Brinkmann1, Monika Fleckenstein1, Ute E. K. Wolf-Schnurrbusch2, Peter Charbel Issa1, Hans-Martin Helb1, Steffen Schmitz-Valckenberg1, Sebastian Wolf2, Frank G. Holz1
1Universitäts-Augenklinik Bonn, 2Inselspital, Bern, Schweiz

Objective
Identification of changes of the vitreoretinal interface in eyes with geographic atrophy by spectral domain (SD) optical coherence tomography (OCT).
Methods
Seventy eyes (70 patients, 23 m, 47 f; 78 ± 13 yrs) with GA were examined by high resolution simultaneous confocal scanning laser ophthalmoscopy (cSLO) and SD-OCT imaging (Spectralis HRA+OCT, Heidelberg Engineering, Germany). The “Eye Tracking” system within the device allows for exact topographic allocation of the in vivo-histologic SD-OCT scans to atrophic areas on fundus autofluorescence (FAF). GA morphology and changes of the epiretinal structure and the posterior vitreous membrane (PVM) can be appreciated at the same time.
Results
We assessed the edge characteristics of the GA: 62.9% of the patients showed garland-like, fuzzy edges of GA, 37.1% had sharply defined edges. Partial epiretinal membrane proliferation was detected in 31.4%, whereas 37.2% had marked epiretinal gliosis. 64.2% had complete posterior vitreous detachment, 35.8% showed foveal adhesions of the PVM. Garland-like edges of atrophy showed statistically significant correlation to marked epiretinal gliosis (p<.001), more so in presence of foveal adhesions of the PVM. Patient age only showed slight inclination (p<.05) to epiretinal gliosis and PVD.
Conclusions
Recent developments in retinal imaging technologies allow for high resolution imaging of morphologic alterations, not only within the different retinal layers, but also in the vitreoretinal interface and the posterior vitreous. Our results may hint at an association between epiretinal changes and GA due to ARMD. Based on these findings we will survey their prospective meaning regarding GA progression and visual function.

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