Original articleConsensus Definition for Atrophy Associated with Age-Related Macular Degeneration on OCT: Classification of Atrophy Report 3
Section snippets
Formation of the Classification of Atrophy Meeting Group
An international team of experts in AMD and AMD imaging research was assembled to address the problem of developing multimodal definitions of atrophy in the setting of AMD. The initial selection of Classification of Atrophy Meetings (CAM) group members was performed by the 3 CAM chairs (S.R.S., G.S., and F.G.H.). Criteria for selection included a history of relevant publications (in AMD pathogenesis and histopathology, imaging technologies, image interpretation and analysis in AMD, and AMD
What Is Atrophy in the Context of Age-Related Macular Degeneration?
In general use, atrophy means a shrinking or withering, particularly because of poor nutrition or disuse. In the context of AMD, the term atrophy means either loss of tissue (typically) or the irreversible attenuation of tissue.
Selection of a Base Imaging Method to Define Atrophy
Given the wide availability of multiple imaging methods to evaluate the fundus, it seems reasonable to incorporate information from multiple imaging sources to confirm the presence of atrophy. However, in such a multimodal system, we believed that it would be prudent to
Discussion
Through the CAM program, a consensus nomenclature and definition for atrophy based on OCT imaging was proposed. The intention of the program was to develop a system that could be used by practitioners for assessing and counseling their patients with AMD. Using OCT findings to define the earliest anatomic changes that portend the future development of atrophy are highly relevant for interventions applied early in the disease process and certainly will accelerate interventional clinical trials
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Financial Disclosure(s): The author(s) have made the following disclosure(s): S.R.S.: Consultant – Allergan, Iconic Therapeutics, Novartis, Thrombogenics, Genentech, Centervue, Heidelberg Engineering; Research support – Optos, Carl Zeiss Meditec, Allergan; Research Instruments – Optos, Carl Zeiss Meditec, Nidek, Centervue, Heidelberg Engineering
R.G.: Financial support – Novartis, Bayer, Genentech
F.G.H.: Financial support – Heidelberg Engineering, Optos, Zeiss, Novartis, Bayer Healthcare, Genentech, Acucela, Boehringer Ingelheim, Alcon, Allergan
S.S.-V.: Financial support – Novartis, Bayer Healthcare, Genentech, Acucela, Alcon, Allergan, Heidelberg Engineering, Formycon/Bioeq; Nonfinancial support – Optos, Heidelberg Engineering, Carl Zeiss Meditec
C.A.C.: Financial support – Hoffman-LaRoche, Heidelberg Engineering, Regeneron, Novartis, Unity, Janssen Cell Therapy
F.B.: Financial support – Novartis, Bayer; Nonfinancial support – Allergan, Heidelberg Engineering
U.C.: Financial support – Novartis, Bayer, Allergan, Heidelberg Engineering, Zeiss
K.C.: Financial support – Genentech, Regeneron, Heidelberg Engineering, Santen, Ophthotech, Acucela, GSK, Roche, Allergan; Other – Ophthotech
R.D.: Financial support – Allergan, GSK, Thrombogenics, KangHong, Ionis; Equity owner – EyeKor, Inc; Employee – EyeKor, Inc
M.F.: Financial support – Heidelberg Engineering, Optos, Novartis, Bayer, Genentech, Roche; Nonfinancial support: Zeiss Meditech, Heidelberg Engineering, Optos; Patent pending – US20140303013 A1
K.B.F.: Consultant – Heidelberg Engineering, Optovue, Optos, Spark Therapeutics; Financial support – Genentech/Roche
G.J.J.: Consultant – Heidelberg Engineering
S.L.: Financial support – Heidelberg Engineering, Carl Zeiss Meditec, Novartis, Allergan, Bayer; Nonfinancial support – Heidelberg Engineering, Carl Zeiss Meditec
J.M.M.: Financial support – Eyerisk Consortium 2020, Novartis, Bayer, Alcon, Roche, Ophthotech; Consultant – Novartis, Bayer, Alcon, Roche, Genentech; Equity owner – Ophthotech, Notalvision
D.P.: Consultant – Novartis, Bayer; Clinical study participation – Roche, Novartis, Bayer
P.J.R.: Research support – Astellas Institute for Regenerative Medicine (AIRM), Carl Zeiss Meditec, Genentech, Tyrogenex; Consultant – Acucela, Apellis, Boehringer-Ingelheim, Carl Zeiss Meditec, Cell Cure Neurosciences, Chengdu Kanghong Biotech, Isarna Therapeutics, Genentech, Healios K.K., Hemera Biosciences, F. Hoffmann-La Roche Ltd., Ocudyne, Ocunexus, Tyrogenex, Unity Biotechnology; Equity Interest – Apellis, Digisight, Ocudyne
D.S.: Consultant – Genentech, Optovue, Bayer, Novartis; Financial support – Allergan, Genentech, Heidelberg Engineering, Regeneron, Optovue, Optovue; Lecturer – Optovue
R.F.S.: Consultant – Topcon Medical Systems, Heidelberg Engineering; Royalties – Topcon Medical Systems, DORC
R.T.: Financial support – Alcon, Allergan, Alimera, Novartis, Bayer, B+L, FCI, Zeiss, Thromgenics, Genentech, Roche; Nonfinancial support – Alcon, Allergan, Novartis, Bayer, B+L, Zeiss
A.T.: Financial support – Novartis, Roche, Bayer Healthcare, Genentech, Allergan, Alcon, Heidelberg Engineering
S.W.: Financial support – Allergan, Bayer, Novartis; Other – Zeiss, Heidelberg Engineering, Optos
G.S.: Financial support – Heidelberg Engineering, Zeiss Meditec, Optovue, Optos, Centervue, Nidek, Novartis, Bayer; Other – Heidelberg Engineering, Zeiss Meditec, Optos, Centervue, Novartis, Bayer, Boeheringer, Allergan, Alcon
Acquisition of human donor eyes and the Project MACULA web site were supported by the National Institutes of Health, Bethesda, Maryland (grant nos.: R01EY06019 and P30 EY003039 [C.A.C.]); EyeSight Foundation of Alabama (C.A.C.); International Retinal Research Foundation (C.A.C.); the Edward N. and Della L. Thome Foundation (C.A.C.); the Arnold and Mabel Beckman Initiative for Macular Research (C.A.C.); and Research to Prevent Blindness, Inc, New York, New York (C.A.C.). Supported by the Lowy Research Medical Institute (travel grant, A.C.B.).
HUMAN SUBJECTS: No human subjects were included in this study.
Author Contributions:
Conception and design: Sadda, Guymer, Holz, Rosenfeld, Spaide, Staurenghi
Analysis and interpretation: Sadda, Guymer, Holz, Schmitz-Valckenberg, Curcio, Bird, Blodi, Bottoni, Chakravarthy, Chew, Csaky, Danis, Fleckenstein, Freund, Grunwald, Hoyng, Jaffe, Liakopoulos, Monés, Pauleikhoff, Rosenfeld, Sarraf, Spaide, Tadayoni, Tufail, Wolf, Staurenghi
Data collection: Sadda, Guymer, Holz, Schmitz-Valckenberg, Curcio, Rosenfeld, Spaide, Staurenghi
Overall responsibility: Sadda, Guymer, Holz, Schmitz-Valckenberg, Curcio, Bird, Blodi, Bottoni, Chakravarthy, Chew, Csaky, Danis, Fleckenstein, Freund, Grunwald, Hoyng, Jaffe, Liakopoulos, Monés, Pauleikhoff, Rosenfeld, Sarraf, Spaide, Tadayoni, Tufail, Wolf, Staurenghi
Supplemental material available at www.aaojournal.org.