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Study aims to identify methodology for least amount of variation, greatest test-retest reliability

Parafoveal retinal vessel density assessment by OCTA in healthy eyes

Retina World Congress 2025 will take place May 8-11. As researchers prepare for their, presentation, we are highlighting the upcoming sessions that are scheduled for this meeting, which will be held in Fort Lauderdale, Florida.

Note: The following list of presentations are in alphabetical order by company. Updates will be added to this article as new information becomes available.

The company highlight Phase 2 results for migaldendranib (MGB), Ashvattha’s investigational subcutaneous treatment for wet age-related macular degeneration (wet AMD) and diabetic macular edema (DME). The presentation, entitled, "Emerging Data om Anti-angiogenic Nanomedicine (Migaldendranib MGB/D-4517.2) for AMD and DME" will be given by Michael Singer, MD on Sunday, May 11, 2025; 11:11 – 11:16 am ET.

Phase 2 clinical data demonstrated that MGB administration lowered production of subretinal fluid reducing or eliminating the need for intravitreal anti-VEGF treatment in both the study eye and fellow eye in wet AMD and DME subjects with bilateral disease. New data indicates that MGB may be the first safe systemic therapy for the treatment of wet AMD and DME without ocular adverse events.

Huma Qamar, Chief Medical Officer at Ocugen will represent Ocugen at Retina World Congress to share a presentation and join retinal surgeons and industry peers during a panel discussion.

Inherited and Rare Retinal Diseases Session
Moderated by Rishi P. Singh, MD, FASRS and Kourous A. Rezaei, MD on Thursday, May 8, 2025, 10:35 – 11:12 AM ET

Ocular Therapeutix will present information at the meeting in Fort Lauderdale regarding the axitinib intravitreal hydrogel clinical trials, the use of its candidate OTX-TKI for diabetic retinopathy, and the HELIOS clinical trial for diabetic retinopathy.

Axitinib Intravitreal Hydrogel: Update on Clinical Trials

Presented by Carl C. Awh, MD, FASRS, on Friday, May 9, 2025, 4:33 – 4:38 PM ET.

Presented by Dilsher S. Dhoot, MD, FASRS on Saturday, May 10, 2025, 8:44 – 8:49 AM ET

Volumetric Macular Fluid Analysis of the Impact of a Single Axitinib Intravitreal Injection (OTX-TKI) from the HELIOS Clinical Trial for Diabetic Retinopathy

Presented by Carl J. Danzig, MD on Saturday, May 10, 2025, 8:52 – 8:57 AM ET

The company will present further insights from Stage 1 of the Phase 3 DIAMOND program reinforcing the efficacy and safety profile of OCS-01 eye drops for DME will also be shared. OCS-01 is being developed to be the first non-invasive treatment for DME, addressing key unmet needs for earlier treatment intervention and for inadequate responders to the current standard of care.

Ashvattha Therapeutics to Present at ARVO, Retina World Congress, and AOS Annual Meeting. Ashvattha Therapeutics. April 15, 2025. Accessed April 16, 2025. https://www.globenewswire.com/news-release/2025/04/15/3061682/0/en/Ashvattha-Therapeutics-to-Present-at-ARVO-Retina-World-Congress-and-AOS-Annual-Meeting.html

Ocugen to Present on Modifier Gene Therapy Platform at Association for Research in Vision and Ophthalmology 2025 Annual Meeting and Retina World Congress. Ocugen Inc. April 29, 2025. Accessed April 30, 2025. https://www.globenewswire.com/news-release/2025/04/29/3070074/0/en/Ocugen-to-Present-on-Modifier-Gene-Therapy-Platform-at-Association-for-Research-in-Vision-and-Ophthalmology-2025-Annual-Meeting-and-Retina-World-Congress.html

Ocular Therapeutix™ to Participate in Upcoming Investor and Scientific Conferences. Ocular Therapeutix. April 29, 2025. Accessed April 29, 2025. https://www.globenewswire.com/news-release/2025/04/29/3070022/0/en/Ocular-Therapeutix-to-Participate-in-Upcoming-Investor-and-Scientific-Conferences.html

Oculis to Present its Innovative Late-Stage Pipeline Candidates at Upcoming Ophthalmology Conferences. Oculis Holding AG. May 1, 2025. Accessed May 1, 2025. https://www.biospace.com/press-releases/oculis-to-present-its-innovative-late-stage-pipeline-candidates-at-upcoming-ophthalmology-conferences

Companies working in the retina space have announced that data from clinical trials will be shared at this year’s meeting in Fort Lauderdale, Florida.

RWC 2025: Companies to share data at meeting in Fort Lauderdale

Optain Health recently announced the close of an oversubscribed $26 million in Series A funding.

 The funding, led by investor Insight Partners, also received participation from existing investors. Optain is a health care technology company using artificial intelligence (AI), robotic retinal imaging, and teleophthalmology to detect eye and systemic disease earlier.

“Our mission is simple: faster, easier, more equitable disease screening,” Jeff Dunkel, CEO of Optain Health, said in a news release. “After 2 years of major international growth, we are ready to scale in the US. This Series A funds our enterprise deployments, opens new markets, and pushes the frontier of what the retina can unveil.”

Optain’s platform is powered by a single, noninvasive test, Oculomics.

 It has a portable robotic camera used for capturing retinal images rapidly without needing the pupil to be dilated. The integrated AI workflows detect sight-threatening eye diseases, including 

Insight Partners and leading health system investors came together for this Series A, including Memorial Hermann Health System, Northwell Health, Novant Health, The Ohio State University Wexner Medical Center, and UPMC. More than 28 million patients across 25 states receive care from these medical systems.

“Optain represents our conviction in the power of better AI—deployed at the edge, inside clinical workflows,” Scott Barclay, managing director at Insight Partners, said in the news release.

“By making retinopathy screening truly accessible, Optain is already changing care delivery—and we believe it will become the upstream gateway in primary care for AI-driven diagnoses across many conditions.”

Other investors that will allow for the growth of Optain’s global footprint into Australia, Europe, the Middle East, and Southeast Asia include Informed Ventures, Lumio Capital, Meridian Ventures, and the UniQuest Extension Fund.

“We’re proud to be translating world-class Australian science into real-world impact,” said Zachary Tan, MD, president of Optain.

 Optain’s technology builds on more than a decade of research, the company noted.

Tan added, “We are making significant investments in new Australian [research and development] and growing our local team, who will lead our global expansion outside of the US. Exporting Australian AI innovation to improve equitable access to health care and patient outcomes around the world is a mission we are proud to lead.”

Aegis Ventures, which also formed the Aegis Digital Consortium, cocreated Optain in 2023. The Aegis Digital Consortium is a collaboration of 11 leading regional US health systems working to develop AI-driven health tech companies.

“Early retinal screening for diabetic retinopathy and chronic disease closes a critical care gap,” John Noseworthy, MD, chairman of the Aegis Digital Consortium and emeritus CEO of Mayo Clinic, said in the news release.

He concluded, “Clinicians have been waiting for a solution that meets patients where they are, and Optain is delivering a best-in-class product that is achieving real adoption. By deploying Optain in patient care and investing in the company, Consortium members have shown strong confidence in its value for enabling early detection and better outcomes."

Health O. Optain Health closes $26 million Series A to bring Oculomics to primary care and beyond. Prnewswire.com. September 10, 2025. Accessed September 12, 2025. 

https://www.prnewswire.com/news-releases/optain-health-closes-26-million-series-a-to-bring-oculomics-to-primary-care-and-beyond-302551962.html

Optain Health secures $26 million in Series A funding to enhance AI-driven retinal disease detection and expand its technology.

Canonical

clinical

Optain Health secures $26 million Series A funding

Belite Bio announced the conclusion of its phase 3 DRAGON study (

), which is investigating tinlarebant in the treatment of adolescent patients with Stargardt disease type 1 (STGD1).

 The company anticipates the release of the topline outcomes in the fourth quarter of 2025 and plans to submit new drug applications in the first half of 2026.

The phase 3, multicenter, randomized, double-masked, placebo-controlled study was randomized 2:1, favoring tinlarebant over placebo.

 The primary efficacy goal is to measure the rate of atrophic lesion growth, as well as evaluate the tolerability and safety of tinlarebant.

 Tinlarebant’s mechanism of action involves minimizing and regulating the serum retinol binding protein 4 (RBP4) levels, which is the primary carrier of retinol from the liver to the eye.

“We are pleased to announce the successful completion of the DRAGON trial,” Belite Bio CEO and Chairman Tom Lin, MMed, PhD, MBA, said in a news release. “This is an important milestone in our mission to bring a treatment to patients living with Stargardt disease.”

DRAGON enrolled 104 participants aged 12 to 20 years from 11 regions, including the US, Australia, Belgium, United Kingdom, Germany, France, Switzerland, China, Netherlands, Hong Kong, and Taiwan.

 Participants must have clinically diagnosed STGD1 with at least 1 mutation identified in the 

 gene, as well as a defined aggregate atrophic lesion size within 3 disc areas as imaged by fundus autofluorescence in the study eye.

Tinlarebant is an oral medication aimed at decreasing the buildup of vitamin A–based toxins, known as bisretinoids.

 Bisretinoids are implicated in retinal diseases such as STGD1 and are also known to contribute to the progression of 

“With no approved therapies available today, tinlarebant has the potential to be the first treatment for this devastating inherited macular degeneration,” Lin said. “We are deeply grateful to the patients, families, investigators, and study teams worldwide who made this clinical trial possible.”

Tinlarebant has received fast-track designation and rare pediatric disease designation in the US; orphan drug designation in the US, Japan, and Europe; and Sakigake designation in Japan for the treatment of patients with STGD1.

Belite Bio wraps up phase III trial of Stargardt disease treatment. Clinical Trials Arena. September 15, 2025. Accessed September 15, 2025. 

https://www.clinicaltrialsarena.com/news/belite-bio-stargardt-disease/

Phase 3, randomized, placebo-controlled study of tinlarebant to explore safety and efficacy in adolescent Stargardt disease (DRAGON). ClinicalTrials.gov. Updated June 7, 2024. Accessed September 15, 2025. 

https://clinicaltrials.gov/study/NCT05244304?term=DRAGON%20phase%203%20stargardt&rank=1

Belite Bio completes its phase 3 trial for tinlarebant, a potential first treatment for Stargardt disease, with results expected in late 2025.

Belite Bio concludes phase 3 DRAGON study for Stargardt disease

 showed that relapsing-remitting multiple sclerosis (MS) potentially can include the morpho-functional involvement of all macular areas and sectors, and this can occur even in patients who have no history of optic neuropathy, reported first author Lucilla Barbano, MD, of the Istituto di Ricovero e Cura a Carattere Scientifico-Fondazione Bietti in Rome.

She and her colleagues published their results in the 

A great deal of research has been conducted, particularly on the macular unmyelinated axons of the retinal ganglion cells (RGCs), to determine the retinal involvement in patients with MS.

 “These neuronal elements, in fact, can be considered as the cellular target of the retinal neurodegenerative process due to MS, as a consequence of the frequent inflammatory process of the optic nerve, known as optic neuritis (ON),” the authors commented.

Optical coherence tomography (OCT) images have shown thinning of the ganglion cell/inner plexiform layer (GCIPL) complex, which is evidence of early inner retinal impairment in patients with MS after ON (MSON eyes).

The reduced amplitude of the pattern electroretinogram from the central RGCs and relative fibers is a valuable hallmark of functionally impaired ganglionic retinal elements and their axons in MSON eyes.

However, in eyes with MS but no history of ON (MSnoON eyes), “although previous OCT segmentation analyses of the inner retina have documented reductions in the macular retinal nerve fiber layer (RNFL) and CGPIL thicknesses,

 few data have been reported on the functional condition of the macula,” Barbano and colleagues commented.

Because of this knowledge gap, the investigators assessed the structure and function of the inner retinal ganglionic elements in selected macular areas based on a topographic evaluation method previously applied to MSON eyes.

The study included 24 patients with MSnoON (mean age, 45.22 ± 5.57 years; 14 women, 10 men; mean duration of MS, 11.07 ± 5.88 years) and 30 control patients who were a similar age (mean age, 45.09 ± 5.08 years). The participants underwent a complete ophthalmologic examination, OCT, and measurement of the multifocal photopic negative response (mfPhNR). The ganglion cell layer (GCL) thickness on OCT images and the response amplitude density (RAD) by the mfPhNR were measured from localized macular regions, including the rings and Early Treatment of Diabetic Retinopathy Study sectors, the authors explained.

The authors reported that their comparison of the MSnoON data from all tested retinal areas with the data obtained from the controls showed that the mean values of the macular GCL thickness and mfPhNR RAD were significantly decreased (

“In the MSonON group, considering both the rings and sectors, the GCL thickness values were significantly and linearly correlated (

 < .01 by Pearson test) with the mfPhNR RAD values,” Barbano and colleagues reported.

They concluded, “Our results suggest that in patients with relapsing–remitting MS in the absence of optic nerve inflammation, a potential primary morpho-functional involvement of the inner macular elements occurs. This impairment involves all macular areas and sectors. Thus, the present study offers scientific bases for the primitive morpho-functional impairment of macular RGCs in eyes with MSnoON and a possibility to compare the results with different populations of MSON eyes,

 in which the retrograde degeneration after an episode of ON could be responsible for the inner retinal damage.”

The hope is that future studies may help to confirm if their conclusions also can be applied to different types of MS disease and to different stages of the disease.

Barbano L, Ziccardi L, Dell’Aquila C, et al. Structural and functional assessment of the macular inner retinal layers in multiple sclerosis eyes without history of optic neuropathy. 

Britze J, Pihl-Jensen, G, Frederiksen JL. Retinal ganglion cell analysis in multiple sclerosis and optic neuritis: a systematic review and meta-analysis. 

Petzold A, Balcer LJ, Calabresi PA, et al. Retinal layer segmentation in multiple sclerosis: a systematic review and meta-analysis. 

Al-Nosairy KO, Horbrügger M, Schippling S, et al. Structure-function relationship of retinal ganglion cells in multiple sclerosis. 

Zahavi O, Nilsson M, Manouchehrinia A, et al. Macular inner retinal layers in multiple sclerosis. 

Bsteh G, Berek K, Hegen H, et al. Macular ganglion cell-inner plexiform layer thinning as a biomarker of disability progression in relapsing multiple sclerosis. 

Del Palomar AP, Cegoñino J, Montolío A, et al. Swept source optical coherence tomography to early detect multiple sclerosis disease. The use of machine learning techniques. 

Ziccardi L, Barbano L, Boffa L, et al. Morphological outer retina findings in multiple sclerosis patients with or without optic neuritis. 

Wicki CA, Hanson JVM, Schippling S. Optical coherence tomography as a means to characterize visual pathway involvement in multiple sclerosis. 

Janáky M, Jánossy Á, Horváth G, Benedek G, Braunitzer G. VEP and PERG in patients with multiple sclerosis, with and without a history of optic neuritis. 

Monsalve P. Decoding PERG: A neuro-ophthalmic retinal ganglion cell function review. 

Falsini B, Bardocci A, Porciatti V, Bolzani R, Piccardi M. Macular dysfunction in multiple sclerosis revealed by steady-state flicker and pattern ERGs. 

Albano V, Dammacco, R, Manni A, et al. Macular ganglion cell-inner plexiform layer defect patterns in multiple sclerosis patients without optic neuritis: a spectral-domain-optical coherence tomography cross-sectional, case-control, pilot study. 

Parisi V, Barbano L, Antonelli G, et al. Topographical correlation between structural and functional impairment of the macular inner retinal layers in multiple sclerosis eyes with a history of optic neuropathy. 

Status of the inner retinal layers in patients with multiple sclerosis

Amir H. Kashani, MD, PhD, is a professor of ophthalmology at the Wilmer Eye Institute in Johns Hopkins University in Baltimore, Maryland. In an interview with 

, Kashani discussed a research paper on OCT-A angiography's potential in detecting early signs of neurodegenerative diseases like Alzheimer disease. 

The study aims to establish a consensus among researchers on analyzing retinal blood flow data. By examining capillary-level changes in the eye, the research offers a noninvasive method to identify high-risk patients for cognitive impairment. The work highlights the potential of AI and machine learning in processing complex medical imaging data to improve early disease detection.

Note: This transcript has been lightly edited for clarity.

 You recently had a very interesting paper published. Can you give the name of that paper and the journal in which it was published?

, and the topic of the publication was using OCT-A angiography data in epidemiologic studies, especially as it relates to Alzheimer's and neurodegenerative diseases. So it's a very exciting and growing field, and I think it was a timely publication.

 Can you talk a little bit about how OCT-A is achieving this sort of biomarker look in the eye for Alzheimer disease and other conditions?

 So OCT-A, first of all, for and I think most people are starting to become familiar with it, but for anybody who isn't, OCT-A is a really excellent modality to measure capillary level perfusion in the eye. Because of the optics of the eye, we can do it noninvasively, which is hard to do in the brain, because you have to penetrate the skull with whatever modality. So things like MRI, PET scans, they just can't measure capillary-level blood flow. 

So with advent of OCT-A we can now measure blood flow in the retina, and the idea is that it's a proxy for perfusion in the CNS, in the intracranial space. This has become a very widely accepted idea that at least some aspects of pathology that occur in the brain for Alzheimer's disease, and perhaps for other diseases like vascular cognitive impairment, are reflected in the tissue of the retina. 

The question is, can we capture a picture of this, literally, in the retina, and hopefully tell us something more about what's happening in the intracranial disease process?

 In conducting this research, how was the study designed to analyze these photos and this data?

 The study that we published was really a first attempt at gaining consensus among a lot of stakeholders. So OCT-A has been around for about 10 years, and we were involved in the initial kind of FDA approval process with one of the main manufacturers and initial utilizations. So it hasn't been around that long. 

A lot of people have collected data, and one of the things we found is that it's a little bit tricky how you use those OCT-A data and how it's acquired. That's where really this consortium started to come together, is to try to get a handle of, "how do we do these analyses," so that one site in Europe and another site in Asia and the US, we can all get consistent interpretations of our data and make sure we're using the best data possible.

That was the motivation for this paper. What we did is we had a group of 7 or 8 universities that are running really large population-based studies and that have collected thousands and thousands of data sets from OCT-A, and we tried to get everybody around the table and say, "What is the best way of analyzing this data so that we don't have these differences?" 

Because right now, there are a lot of differences between published studies by group X and group Y. That was really the goal of this particular study: to get some consensus in terms of study design, analytical methods, and how do you use good quality data to generate the results that you want?

 Taking it one step further with more of a consensus among different stakeholders in the area, in the field, how might this apply to future technologies, whether we're talking about AI or whether we're talking about a large language model in the space?

 I think it has huge implications for how we collect data, because, one of the things that we've learned from one of the study sites, which was the Framingham Heart Study, was that, when you collect data from both eyes of an individual, we don't necessarily see the exact same correlation in the data between 2 eyes. That could be because of the way the data are collected, or it could be because of biological differences between blood flow to each eye. We're not absolutely sure about that. 

So a lot of times, people will a conductive study, and they'll dilate 1 eye, because they don't want to inconvenience the patient. Or, for example, in neurologic studies, the patient has to perform another task after the eye test. So if you dilate both, it can't be functional. It turns out that that may be an important variable. So if you just randomly dilate somebody, rather than systematically doing it, you may be introducing a bias one way or the other, or you may be missing something. So that's one thing we found at one of the sites.

I think the other things that we found are that how you collect these data, in terms of the size of the scans and how much of the retina you're looking at, makes a big difference in how we analyze them, because there are small vessels and there are large vessels, and there's small vascular disease and large vascular disease. Those things, I think, had been a little bit overlooked in the past, but I think that it's coming to to the forefront.

In terms of AI, the data sets that we're collecting, they're huge data sets, and these are large volumes, and we're just starting to get an appreciation for how these capillaries in the retina connect to each other and connect to large vessels. 

The role of AI and machine learning in analyzing these vascular patterns, I think, is going to be very important. We've already started developing software to remotely assess the quality of data at these different sites. One of the things that came through was that, you know, site X has 10,000 images that they need to review, and it's a very labor-intensive process, because you need somebody who's experienced in reading these images, and oftentimes, it's clinicians who are doing it, but they don't have time to read 10,000 images.

So one really active application of AI right now is to develop a method of looking through 10,000 images, picking the best ones for the analysis, and then leaving the rest as a secondary analysis, or saying, well, these may not give us as reliable results. That, in and of itself, is a big step forward, because all the sites were saying, we don't have a really great way of doing this.

 For the average ophthalmologist, or someone who's conducting these scans, looking at these scans on an individual level, what takeaways would you have for them as they start to incorporate this kind of research down the line?

 I think this is really exciting because it's putting ophthalmology perhaps in the driver's seat, or at least in a position where we can help our colleagues in neurology and even other specialties to risk-stratify patients. So I'm not so sure we're going to diagnose Alzheimer disease. 

I think our neurology colleagues are very good at that, but they're not very good at saying who is going to develop Alzheimer disease in the next 10 years, and who should we send for MRI testing or cognitive testing or PET scans, because each one of those tests is hard, much harder to do than OCT-A, which takes about 10 or 15 minutes, and for which you don't even have to dilate somebody. So MRIs are a couple hours and cost is very high. 

Cognitive testing requires a very experienced neuropsychologist to sit down an hour and a half of discussion back and forth. Language can be a barrier if the patient doesn't speak. You're not going to get good cognitive evaluations. PET scans require radiation to the body.

So, the issue is, how are you going to identify all these people to screen them? The other real practical implication is that when you want to do a clinical trial to try to find a treatment, you want to find a group of people who are at high risk for the disease, and you can't do an MRI on thousands and thousands and thousands of people. It's just not feasible. So hopefully we can provide a method for our neurology colleagues to say, hey, out of these 10,000 people, these 1000 are the highest risk group based on the scans that we've done. 

Let's try to focus on them and expand our really valuable resources on those groups of people.

 Are there any other areas you want to speak to, or anything you feel didn't get mentioned?

 It's really exciting to be able to look in the eye and assess capillary level changes in people who don't necessarily have a problem right now, but are on their way to developing a problem. We've done this now in a couple of different studies before this consortium, and I think that's where some of the interest is starting to arise. 

You know, when we look at people who have, for example, diabetes and hypertension, we notice that there's an increased chance that they have fewer capillaries or fewer areas of perfusion compared to people who are not diabetic and hypertension, and that may be reflecting an intracranial process as well. 

Similarly, we found people who have specific kinds of genetic mutations, even though they have no visual symptoms or cognitive symptoms, tend to have lower capillary density in their retina, which might mean that they're more predisposed to developing cognitive impairment in the future, whether from vascular disease or from Alzheimer. 

I think we're providing very useful information by looking at these subtle, but really important changes, in the eyes of people and trying to correlate them with their clinical and cognitive status from a neurology standpoint.

 Is there an age range with this kind of consensus looked at, or was it, you know, were we looking at a specific population of retirement age or younger?

 I think in general, cognitive impairment tends to be a problem, primarily in the [older] population. Alzheimer disease is the one we all traditionally think about, but stroke and vascular cognitive impairment, which is kind of not the typical stroke that we think of, but more microvascular, chronic stroke, are all really big problems, and it is very hard to distinguish those categories among the older groups. 

So that's primarily where we're interested, but we don't really know if this has applications earlier on, and it would certainly be interesting to study patients earlier to see if earlier causes of cognitive impairment are associated with it. I think we're pretty sure that we can pick out the vascular component of a disease process that is contributing to cognitive decline. 

The question is, how do we implement that in our studies, reliably and repeatedly, so that everybody can get the same results?

OCT-A angiography can help reveal early neurodegenerative disease signs, offering a noninvasive method for identifying high-risk patients through retinal analysis.

Q&A: Amir Kashani on biomarkers for Alzheimer disease

A new study tackled the topic of drusen regression without accompanying atrophy and forwarded the “drusen ooze” hypothesis to explain this phenomenon (ie, that the content of the drusen moves to the subretinal space through defects in the retinal pigment epithelium [RPE]), which may explain 

 reported Jordi Monés, MD, PhD. He is affiliated with the Institut de la Macula, Centro Medico Teknon, and the Barcelona Macula Foundation, both in Barcelona, and the John A. Moran Eye Center, University of Utah, Salt Lake City.

He and his colleagues explained that although great strides have been made in the understanding of the biologic processes that precede the development of atrophy of RPE and photoreceptors, they recognized a subset of atrophy that results from the collapse of soft drusen, marking a crucial stage in disease progression.

“Although considerable attention has been focused on elucidating the mechanisms underlying drusen collapse and subsequent atrophy, a curious phenomenon has been poorly explained: drusen regression without accompanying atrophy. Despite its well-documented occurrence, it lacks a comprehensive explanation,"

They conducted this study to determine how often and why spontaneous soft drusen regresses without atrophy (DRwoA) in patients who had intermediate or atrophic 

The investigators retrospectively reviewed images from 640 consecutive eyes of 320 patients who had been followed for 2 years or longer. Among these, 427 eyes of 262 patients were identified who had intermediate or atrophic AMD and no present or past exudative AMD.

The main outcome measures were DRwoA with integrity of the RPE and repositioning over Bruch’s membrane; DCwA in the same area simultaneously referred to as “sentinel” DCwA; and the reversibility of features of incomplete RPE, outer retinal atrophy (iRORA), and the areas (“halos”) of DRwoA around the sentinel drusen.

Evaluation of the images obtained from the 427 eyes identified 53 occurrences of DRwoA, representing 24.17% of the eyes with soft drusen. In 50 of the cases (94.33%), a nearby sentinel DCwA was seen. In 58% of the cases, a well-identifiable halo of drusen disappearance around the sentinel DCwA was clearly visible, the investigators reported.

A previous study theorized that “drusen formation and reabsorption are dynamic processes that can occur concurrently in the macula.

In addition, the potential prognostic implications of drusen regression and its therapeutic implications for macular alteration have been pointed out."

Monés and colleagues explained that the most accepted hypothesis for the disappearance of drusen material during drusen regression “is reduced secretion by altered RPE, especially when it dies, causing it to stop producing drusen material and leading to the collapse of the drusen."

Those authors reported in a separate study that “RPE cells on the drusen apex either migrate into the retina or die, and the drusen collapses because the RPE is not present to maintain it.”

However, Monés and colleagues countered that the hypothesis does not explain drusen regression with the disappearance of drusen material with normal underlying RPE.

Researchers conducted this study to determine how often and why spontaneous soft drusen regresses without atrophy in patients who had intermediate or atrophic age-related macular degeneration.

Malvika Arya, BS

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