OCT Biomarkers for Late AMD Determined Using Amish Population

Vitelliform lesions were found to have a strong association with progression to late AMD in this study. Photo: Virginia Monteith Hodges, OD. Click image to enlarge. In 2019, a research team published their findings for a study called the Amish Eye Study, which examined factors associated with age-related macular degeneration (AMD) and other ocular traits within the Amish population. Using this data, physicians can better understand what impacts the state of ocular health for isolated groups.Recently, in a paper published in Retina, researchers around the United States used the reported findings from the Amish Eye Study to determine risk factors for progression to late-stage AMD. Using baseline OCT results, the investigators evaluated scans for the presence of cuticular drusen, acquired vitelliform lesions (AVL), subretinal drusenoid deposits (SDD), high drusen volume, intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), thick or thin double-layer sign, and incomplete retinal pigment epithelium and outer retinal atrophy (iRORA). Then, the team calculated the prevalence of each biomarker by analyzing data from subjects who progressed to late AMD at two-year follow-up.The Amish Eye Study yielded 1,332 eyes from 666 subjects who were considered for this study. However, after selecting cases that met the two-year follow-up criteria, presented with early or intermediate AMD at baseline and progressed to late AMD at follow-up, only 26 eyes remained. Of these remaining individuals, cuticular drusen was the most prevalent finding (52.3%). This was followed by IHRF (17.3%), hDC (16%), thin double-layer sign (11.9%), SDD (8.2%), iRORA (7.8%), AVL (7%) and high drusen volume (2.5%).Additionally, subfoveal choroidal thickness (SFCT) measurements were assessed for this study. Researchers observed a mean SFCT of 243.23 ± 75.45 μm. Lower SFCT measurements along with thick double-layer sign, iRORA, AVL, SDD, IHRF and hDC were found to be associated with an increased risk of AMD progression after researchers calculated their findings using a univariate analysis model. However, a multivariate regression model revealed that only the presence of iRORA and AVL were significantly associated, IHRF was borderline significant, and other baseline features showed no statistical significance.“These findings may facilitate risk prognostication and stratification in clinical practice and early intervention clinical trials,” concluded the authors in their paper. “Future research could further explore whether different subtypes or spatial distributions of cuticular drusen have varying impacts on progression in this cohort and incorporate quantitative or volumetric OCT biomarker measurements to improve risk stratification. Additionally, using iRORA as an endpoint to investigate risk factors could provide a deeper understanding of the entire AMD disease spectrum.”Click here for the journal source. Chung YC, Alhelaly M, Nittala MG, et al. Optical coherence tomography risk factors for progression to late-stage age-related macular degeneration in the Amish Eye Study. Retina. January 21, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.