Incomplete Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration: Classification of Atrophy Meeting Report 4.
Journal
Ophthalmology
ISSN: 1549-4713
Titre abrégé: Ophthalmology
Pays: United States
ID NLM: 7802443
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
22
03
2019
revised:
26
08
2019
accepted:
24
09
2019
pubmed:
12
11
2019
medline:
19
6
2020
entrez:
12
11
2019
Statut:
ppublish
Résumé
To describe the defining features of incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA), a consensus term referring to the OCT-based anatomic changes often identified before the development of complete RPE and outer retinal atrophy (cRORA) in age-related macular degeneration (AMD). We provide descriptive OCT and histologic examples of disease progression. Consensus meeting. Panel of retina specialists, including retinal imaging experts, reading center leaders, and retinal histologists. As part of the Classification of Atrophy Meeting (CAM) program, an international group of experts analyzed and discussed longitudinal multimodal imaging of eyes with AMD. Consensus was reached on a classification system for OCT-based structural alterations that occurred before the development of atrophy secondary to AMD. New terms of iRORA and cRORA were defined. This report describes in detail the CAM consensus on iRORA. Defining the term iRORA through OCT imaging and longitudinal cases showing progression of atrophy, with histologic correlates. OCT was used in cases of early and intermediate AMD as the base imaging method to identify cases of iRORA. In the context of drusen, iRORA is defined on OCT as (1) a region of signal hypertransmission into the choroid, (2) a corresponding zone of attenuation or disruption of the RPE, and (3) evidence of overlying photoreceptor degeneration. The term iRORA should not be used when there is an RPE tear. Longitudinal studies confirmed the concept of progression from iRORA to cRORA. An international consensus classification for OCT-defined anatomic features of iRORA are described and examples of longitudinal progression to cRORA are provided. The ability to identify these OCT changes reproducibly is essential to understand better the natural history of the disease, to identify high-risk signs of progression, and to study early interventions. Longitudinal data are required to quantify the implied risk of vision loss associated with these terms. The CAM classification provides initial definitions to enable these future endeavors, acknowledging that the classification will be refined as new data are generated.
Identifiants
pubmed: 31708275
pii: S0161-6420(19)32102-5
doi: 10.1016/j.ophtha.2019.09.035
pmc: PMC7218279
mid: NIHMS1544823
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
394-409Subventions
Organisme : NEI NIH HHS
ID : R01 EY024091
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY012951
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY006109
Pays : United States
Organisme : NEI NIH HHS
ID : P30 EY019007
Pays : United States
Organisme : NEI NIH HHS
ID : R24 EY027285
Pays : United States
Organisme : NEI NIH HHS
ID : P30 EY003039
Pays : United States
Informations de copyright
Copyright © 2019 American Academy of Ophthalmology. All rights reserved.
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