Optical coherence tomography risk factors for development of late age related macular degeneration in the fellow eyes of patients enrolled in the HARBOR Study

Abstract Purpose To evaluate the relationship between optical coherence tomography (OCT) features and the progression to late age related macular degeneration (AMD) in the fellow eyes of patients enrolled in the 24-month HARBOR study (NCT00891735) for neovascular AMD. Design post hoc analysis of a phase 3 multicenter, prospective, randomized, double-masked, active treatment-controlled clinical trial. Participants Evaluable subjects (N=501) with macular neovascularization (MNV) secondary to neovascular AMD and early or intermediate AMD in the fellow eye. Methods Volume OCT scans from 501 fellow eyes of 501 patients with MNV were reviewed. Baseline OCT features that were assessed included intraretinal hypereflective foci (IHRF), hyporeflective foci (hRF) within drusenoid lesions (DLs), subretinal drusenoid deposits (SDD) and drusen volume (DV) ≥ 0.03 mm 3 . OCT images at months 6, 12, 18 and 24 were graded by masked graders for late AMD (defined as MNV and/or complete retinal pigment epithelium and photoreceptor atrophy (cRORA)). Subject demographic (age, gender, smoke exposure) characteristics and the baseline OCT features were correlated with progression to late AMD. Main Outcome Measures Incidence of late AMD, Hazard ratio (HR) for demographics and OCT risk factors. Results At month 24, 33.13% (166/501) eyes developed late AMD: 20.96% (105/501) developed cRORA while 12.18% (61/501) developed MNV. Baseline demographic factors were not significantly associated with development of late AMD while significant associations were identified for all OCT features. IHRF had a HR of 5.21 (95% confidence interval (CI): 3.29-8.26); hRF within DLs had a HR of 2.42 (95% CI: 1.74-3.38); SDD had a HR of 1.95 (95% CI: 1.34-2.82); DV ≥ 0.03 mm 3 had a HR of 1.46 (95% CI: 1.03-2.07). The correlation remained significant when considering only the progression to cRORA and MNV alone, except for DV which was not significantly associated with progression to MNV. Conclusions we confirmed that four previously reported OCT risk factors were associated with progression to late AMD in the fellow eyes of subjects newly diagnosed with MNV. Although outcomes > 2 years were not evaluated, these findings may help to identify high risk AMD patients.