Guymer, Robyn H., Rosenfeld, Philip J., Curcio, Christine A., Holz, Frank G., Staurenghi, Giovanni, Freund, K. Bailey ORCID: 0000-0002-7888-9773, Schmitz-Valckenberg, Steffen, Sparrow, Janet, Spaide, Richard F., Tufail, Adnan, Chakravarthy, Usha, Jaffe, Glenn J., Csaky, Karl, Sarraf, David, Mones, Jordi M., Tadayoni, Ramin, Grunwald, Juan, Bottoni, Ferdinando, Liakopoulos, Sandra, Pauleikhoff, Daniel, Pagliarini, Sergio, Chew, Emily Y., Viola, Francesco, Fleckenstein, Monika, Blodi, Barbara A., Lim, Tock Han, Chong, Victor ORCID: 0000-0002-7693-522X, Lutty, Jerry, Bird, Alan C. and Sadda, Srinivas R. (2020). Incomplete Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration Classification of Atrophy Meeting Report 4. Ophthalmology, 127 (3). S. 394 - 410. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1549-4713

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Abstract

Purpose: 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. Design: Consensus meeting. Participants: Panel of retina specialists, including retinal imaging experts, reading center leaders, and retinal histologists. Methods: 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. Main Outcome Measures: Defining the term iRORA through OCT imaging and longitudinal cases showing progression of atrophy, with histologic correlates. Results: 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. Conclusions: 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. (C) 2019 by the American Academy of Ophthalmology

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Guymer, Robyn H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenfeld, Philip J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Curcio, Christine A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holz, Frank G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staurenghi, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Freund, K. BaileyUNSPECIFIEDorcid.org/0000-0002-7888-9773UNSPECIFIED
Schmitz-Valckenberg, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sparrow, JanetUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spaide, Richard F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tufail, AdnanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chakravarthy, UshaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jaffe, Glenn J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Csaky, KarlUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sarraf, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mones, Jordi M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tadayoni, RaminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grunwald, JuanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bottoni, FerdinandoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liakopoulos, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pauleikhoff, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pagliarini, SergioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chew, Emily Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Viola, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fleckenstein, MonikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blodi, Barbara A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lim, Tock HanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chong, VictorUNSPECIFIEDorcid.org/0000-0002-7693-522XUNSPECIFIED
Lutty, JerryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bird, Alan C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sadda, Srinivas R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-343524
DOI: 10.1016/j.ophtha.2019.09.035
Journal or Publication Title: Ophthalmology
Volume: 127
Number: 3
Page Range: S. 394 - 410
Date: 2020
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1549-4713
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SUBRETINAL DRUSENOID DEPOSITS; GEOGRAPHIC-ATROPHY; RETICULAR PSEUDODRUSEN; PROGRESSION; EYES; CLASSIFICATION; PREDICTOR; FEATURESMultiple languages
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34352

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