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Lindenberg S, Mahmoudi A, Oncel D, Corradetti G, Oncel D, Emamverdi M, Almidani L, Farahani A, Wakatsuki Y, He Y, Saju M S, Lee WK, Wykoff CC, Sarraf D, Freund KB, Sadda SR. Acquired Vitelliform Lesions in Intermediate Age-Related Macular Degeneration: A Cross Sectional Study. Ophthalmol Retina 2024; 8:854-862. [PMID: 38631656 DOI: 10.1016/j.oret.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE This study aims to define the characteristics of acquired vitelliform lesions (AVLs) in patients with intermediate age-related macular degeneration (iAMD). DESIGN Retrospective, observational, cross sectional study. SUBJECTS This study included 217 eyes with AVLs associated with iAMD, and an equivalent number of control patients. METHODS OCT scans were evaluated for qualitative and quantitative parameters at both the eye and lesion level. Eye-level parameters included the presence of: hyporeflective core drusen, intraretinal hyperreflective foci (IHRF), subretinal drusenoid deposits, macular pachyvessels, central retinal thickness, and central choroidal thickness. Lesion-level qualitative parameters included the presence of ellipsoid zone (EZ) and external limiting membrane disruption overlying the AVL, IHRF overlying the AVL, AVL overlying drusen, pachyvessels under the AVL, a solid core within AVL, and AVL location. Lesion-level quantitative characteristics included AVL height and width, AVL distance from the fovea, and sub-AVL choroidal thickness. MAIN OUTCOME MEASURES The primary outcomes assessed included the frequency of IHRF, the presence of macular pachyvessels, central choroidal thickness, and the dimensions (both height and width) of AVLs. RESULTS Comparing the AVL and control groups, the frequency of IHRF (AVL: 49.3% vs. control: 26.3%) and macular pachyvessels (37.3% vs. 6.9%) was significantly higher in the AVL case group, and the central choroidal thickness (256.8 ± 88 μm vs. 207.1± 45 μm) was thicker in the AVL group. Acquired vitelliform lesions located over drusen, with overlying IHRF, or situated subfoveally, and AVL lesions with EZ disruption were found to have a greater lesion height and width compared with AVL lesions lacking these characteristics (P value < 0.001 for all). Additionally, a significant negative correlation was observed between the distance from the fovea and AVL height (Spearman rho: -0.19, P = 0.002) and width (Spearman rho: -0.30, P = 0.001). CONCLUSIONS This study represents the largest reported cohort of AVL lesions associated with iAMD. Novel findings include the higher frequency of pachyvessels in addition to the presence of a thicker choroid in these eyes, as well as the greater height and width of AVL closer to the foveal center. These findings may offer insights into pathophysiologic mechanisms underlying the development of AVL. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Sophiana Lindenberg
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California
| | - Alireza Mahmoudi
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Deniz Oncel
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Giulia Corradetti
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Damla Oncel
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Mehdi Emamverdi
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Louay Almidani
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alireza Farahani
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Yu Wakatsuki
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California
| | - Ye He
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Stanley Saju M
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - Won Ki Lee
- Nune Eye hospital, Seoul, Republic of South Korea
| | - Charles C Wykoff
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - David Sarraf
- Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York
| | - Srinivas R Sadda
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, California; Department of Ophthalmology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California.
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