TY - JOUR
T1 - Acquired Vitelliform Lesions in Intermediate Age-Related Macular Degeneration
T2 - A Cross Sectional Study
AU - Lindenberg, Sophiana
AU - Mahmoudi, Alireza
AU - Oncel, Deniz
AU - Corradetti, Giulia
AU - Oncel, Damla
AU - Emamverdi, Mehdi
AU - Almidani, Louay
AU - Farahani, Alireza
AU - Wakatsuki, Yu
AU - He, Ye
AU - Saju M, Stanley
AU - Lee, Won Ki
AU - Wykoff, Charles C.
AU - Sarraf, David
AU - Freund, K. Bailey
AU - Sadda, Srinivas R.
N1 - Publisher Copyright:
© 2024 American Academy of Ophthalmology
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
KW - Acquired vitelliform lesions (AVLs)
KW - Age-related macular degeneration (AMD)
KW - Intraretinal hyperreflective foci
KW - Retinal disorders
KW - Subretinal drusenoid deposits
KW - Fluorescein Angiography/methods
KW - Cross-Sectional Studies
KW - Follow-Up Studies
KW - Retinal Drusen/diagnosis
KW - Humans
KW - Middle Aged
KW - Male
KW - Choroid/pathology
KW - Visual Acuity
KW - Macular Degeneration/diagnosis
KW - Tomography, Optical Coherence/methods
KW - Aged, 80 and over
KW - Female
KW - Retrospective Studies
KW - Aged
KW - Fundus Oculi
KW - Vitelliform Macular Dystrophy/diagnosis
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U2 - 10.1016/j.oret.2024.04.009
DO - 10.1016/j.oret.2024.04.009
M3 - Article
C2 - 38631656
AN - SCOPUS:85192992890
SN - 2468-6530
VL - 8
SP - 854
EP - 862
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 9
ER -