ArticleBMJ open ophthalmology2025
Multimodal imaging biomarkers for progression from intermediate to advanced age-related macular degeneration (AMD): a 10-year prospective longitudinal cohort study from the University of Colorado AMD registry.
Article in BMJ open ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Interpreting Hyperreflective Foci in Age-Related Macular Degeneration: A Critical Review of Cell Origins, Evolving Terminology and Clinical Utility.Clinical & experimental ophthalmology · 2026Review
- Visual Functioning and Progression from Intermediate Age-Related Macular Degeneration (AMD) to Advanced AMD.Ophthalmic epidemiology · 2026Article
- Imaging Biomarkers To Predict Progression of Intermediate AMD with Avascular Pigment Epithelial Detachment in the University of Colorado AMD Registry.Research square · 2026Article
- Geographic Atrophy on Fundus Autofluorescence and Color Fundus Photographs: Association with Deep Visual Sensitivity Losses.Ophthalmology science · 2026Article
- Predicting risk of progression of early to late AMD in the aging eye through imaging and multimodal evaluation: PRIME study protocol.PloS one · 2026Article
- SRF and SHRM in nAMD: Retrospective Analysis of Visual Prognosis.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- AI-Based Response Classification After Anti-VEGF Loading in Neovascular Age-Related Macular Degeneration.Diagnostics (Basel, Switzerland) · 2025Article
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12 authors.
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Abstract
objectiveTo evaluate multimodal imaging (MMI) biomarkers for predicting progression from intermediate to advanced age-related macular degeneration (AMD). METHODS AND ANALYSIS: This prospective longitudinal cohort study included patients with intermediate AMD (iAMD) enrolled in the University of Colorado AMD registry between July 2014 and August 2023, with follow-up through February 2024. At enrolment, patients' medical histories and MMI were collected. Baseline and follow-up imaging were reviewed for progression to geographic atrophy (GA) and neovascular AMD (nAMD). Univariate and multivariable Cox proportional hazard modelling with competing risks to determine HRs for progression.
resultsA total of 367 patients (733 eyes) with iAMD were included in the study, with a median follow-up of 27.8 months. During this period, 100 eyes progressed to GA, 58 to nAMD. Adjusted for age, BMI and hypertension, progression to nAMD was significantly associated with soft drusen (HR 5.31, 95% CI 1.95 to 14.4, p=0.001), pigmentary changes (HR 2.74, 95% CI 1.52 to 4.92, p=0.0008) on colour fundus photography (CFP) and subretinal hyper-reflective material (SHRM) (HR 3.36, 95% CI 1.88 to 6.02, p<0.0001) and intraretinal hyper-reflective foci (IHRF) (HR 3.12, 95% CI 1.74 to 5.57, p=0.0001) on optical coherence tomography (OCT). Adjusted for age, progression to GA was predicted by soft drusen (HR 1.90, 95% CI 1.11 to 3.27, p=0.020), drusenoid pigment epithelial detachment (PED) (HR 5.51, 95% CI 2.49 to 12.2, p<0.0001), avascular non-drusenoid PED (HR 6.59, 95% CI 1.54 to 28.1, p=0.011), pigmentary changes (HR 4.44, 95% CI 2.84 to 6.96, p<0.0001) on CFP and nnSRF (HR 6.41, 95% CI 1.39 to 29.6, p=0.017), SHRM (HR 2.55, 95% CI 1.45 to 4.49, p=0.001), drusenoid PED (HR 2.25, 95% CI 1.43 to 3.55, p=0.0005), avascular non-drusenoid PED (HR 4.67, 95% CI 2.45 to 8.92, p<0.0001), IHRF (HR 6.27, 95% CI 3.89 to 10.1, p<0.0001) and incomplete retinal pigment epithelium and outer retinal atrophy (HR 9.42, 95% CI 5.82 to 15.2, p<0.0001) on OCT (table 3).
conclusionsKey imaging biomarkers associated with the progression were identified, which may offer prognostic information for providers. However, the study is limited by its predominantly Caucasian population and single-centre design, which may affect the generalisability of certain biomarkers.
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