Relative ellipsoid zone reflectivity and its association with disease severity in age-related macular degeneration: a MACUSTAR study report
Marlene Saßmannshausen, Charlotte Behning, Ben Isselmann, Matthias Schmid, Robert P. Finger, Frank G. Holz, Steffen Schmitz-Valckenberg, Maximilian Pfau, Hansjürgen Agostini, Lebriz Altay, R. Atia, Francesco Bandello, P. G. Basile, Charlotte Behning, M. Belmouhand, Moritz Berger, Alison M. Binns, Camiel J. F. Boon, M. Böttger, Christine Bouchet, John Brazier, Thomas Butt, C. Carapezzi, Jill Carlton, Ângela Carneiro, A. Charil, Rafaela Vitoria Guilherme Coimbra, Mariano Cozzi, David P. Crabb, José Cunha‐Vaz, Claudia Dahlke, Luís de Sisternes, Hannah Dunbar, Robert P. Finger, Emily Fletcher, H. Floyd, C. Francisco, Matthias Gutfleisch, Ruth Hogg, Frank G. Holz, Carel B. Hoyng, A. Kilani, Jörn Krätzschmar, L. Kühlewein, Michael Larsen, Sérgio Leal, Yara Lechanteur, Ulrich F. O. Luhmann, A. Lüning, I. Marques, Cecília Martinho, Giovanni Montesano, Z. Mulyukov, Michel Pâques, Maurízio Battaglia Parodi, Mariacristina Parravano, S. Penas, Terry M. Peters, Tünde Pető, Maximilian Pfau, Stephen Poor, Siegfried Priglinger, Donna Rowen, Gary S. Rubin, José‐Alain Sahel, Clarisa Sánchez, O. Sander, Marlene Saßmannshausen, Matthias Schmid, Steffen Schmitz-Valckenberg, H. Schrinner-Fenske, J. Siedlecki, Rufino Silva, A Skelly, Eric H. Souied, Giovanni Staurenghi, L. Stöhr, Deanna J. Taylor, Jan Henrik Terheyden, Sarah Thiele, Adnan Tufail, Monica Varano, L. Vieweg, Ludmila Wintergerst, Anna Wolf, Nadia Zakaria, Sarah Thiele, Sarah Thiele, Sarah Thiele
Abstract
Quantification of the relative ellipsoid zone reflectivity (rEZR) might be a structural surrogate parameter for an early disease progression in the context of age-related macular degeneration (AMD). Within the European multicenter, cross-sectional MACUSTAR study, we have devised an automatic approach to determine the mean rEZR [arbitrary units, AU] at two independent visits in SD-OCT volume scans in study participants. Linear mixed-effects models were applied to analyze the association of AMD stage and AMD associated high-risk features including presence of pigmentary abnormalities, reticular pseudodrusen (RPD), volume of the retinal-pigment-epithelial-drusenoid-complex (RPEDC) with the rEZR. Intra-class correlation coefficients (ICC) were determined for rEZR reliability analysis. Within the overall study cohort (301 participants), we could observe decreased rEZR values (coefficient estimate ± standard error) of - 8.05 ± 2.44 AU (p = 0.0011) in the intermediate and of - 22.35 ± 3.28 AU (p < 0.0001) in the late AMD group. RPD presence was significantly associated with the rEZR in iAMD eyes (- 6.49 ± 3.14 AU; p = 0.0403), while there was a good ICC of 0.846 (95% confidence interval: 0.809; 0.876) in the overall study cohort. This study showed an association of rEZR with increasing disease severity and the presence of iAMD high-risk features. Further studies are necessary to evaluate the rEZR's value as a novel biomarker for AMD and disease progression.