En Face Optical Coherence Tomography Imaging for the Detection of Nascent Geographic Atrophy

PURPOSE: To determine if en face optical coherence tomography (OCT) imaging can identify nascent geographic atrophy (nGA) in eyes with intermediate age-related macular degeneration (iAMD). DESIGN: Retrospective observational case series. METHODS: Patients with iAMD from the COMPLETE study at the Bascom Palmer Eye Institute were evaluated to determine if nGA was present at baseline and at follow-up using high-density Spectralis OCT B-scans and en face OCT images from the Cirrus OCT instrument. If available, additional en face OCT images and B-scans were analyzed at follow-up times beyond the 52-week period. RESULTS: A total of 37 eyes (27 patients) were evaluated for at least 1 year using both B-scans and en face images. Two drusen suspicious for nGA at baseline were identified, but neither druse developed GA after 24 and 62 months of follow-up, respectively. Another druse displayed hypertransmission into the choroid at week 52 on B-scan imaging and was classified as nGA. En face OCT imaging identified this druse as a focal bright area. Drusen breakdown occurred during a follow-up of 39 months. CONCLUSIONS: En face OCT imaging appeared to be as useful as routine B-scan imaging for identifying areas suspicious for nGA in this population from the COMPLETE Study. Additional longitudinal follow-up of eyes with drusen is needed to determine if en face OCT imaging can replace the evaluation of individual B-scans for the detection of nGA. (C) 2016 Elsevier Inc. All rights reserved.