{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:54:47Z","timestamp":1762102487833,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T00:00:00Z","timestamp":1581897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canon Inc"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess geographic atrophy (<jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>) using a multimodal imaging approach, focusing on alterations at the level of the retinal pigment epithelium (<jats:styled-content style=\"fixed-case\">RPE<\/jats:styled-content>) and the choriocapillaris (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) layers, by lesion demarcation, and assessment of morphological alterations within the atrophic area and in the transition zone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010seven eyes of 34 patients with atrophic age\u2010related macular degeneration (<jats:styled-content style=\"fixed-case\">AMD<\/jats:styled-content>) were included in this prospective, observational, cross\u2010sectional study. Multimodal imaging using wide\u2010field polarization\u2010sensitive optical coherence tomography (<jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>), optical coherence tomography angiography (<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\u2010A) and fundus autofluorescence (<jats:styled-content style=\"fixed-case\">FAF<\/jats:styled-content>) was performed. The images were overlaid and used to analyse and compare alterations in the retina and the <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean atrophic lesion size was 8.15\u00a0mm<jats:sup>2<\/jats:sup> (range: 2.23\u201317.23\u00a0mm<jats:sup>2<\/jats:sup>). In 52 of 57 eyes (91%), <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\u2010A displayed focal hypodense areas at the <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> level in the transition zone of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>, as well as increased focal depolarizing material (e.g. melanin\u2010containing structures) showed in <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content> en face depolarizing material maps. These regions of increased depolarizing material at the transition zone corresponded to the hypodense areas on <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\u2010A scans. All 57 eyes presented with abnormal <jats:styled-content style=\"fixed-case\">FAF<\/jats:styled-content> patterns at the transition zone. All 57 eyes showed distinct alterations of <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> flow pattern architecture. Six eyes (11%) demonstrated reduced and three eyes (5%) a complete loss of <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> flow pattern architecture across the entire area of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>, while 48 of 57 eyes (84%) presented with irregular mixed patterns of different focal alterations of <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> flow architecture within the area of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>. Reduced <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> patterns exceeding <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> lesion margins into the transitional zone were found in all eyes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Optical coherence tomography angiography images revealed different degrees of flow impairment within the atrophic lesion area and its transition zone. Alterations in <jats:styled-content style=\"fixed-case\">RPE<\/jats:styled-content> morphology and tissue integrity resulting in accumulation of depolarizing material, such as melanin, could result in misinterpretation of <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\u2010A imaging in areas in the shadow of depolarizing material. These changes seem to be partially independent from autofluorescence altering processes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14352","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T06:51:35Z","timestamp":1582008695000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Relationship between morphological and vascular alterations in geographic atrophy using a multimodal imaging approach"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1863-5795","authenticated-orcid":false,"given":"Alexander","family":"Hecht","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"},{"name":"Department of Ophthalmology Vienna Clinical Trial Center Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Pollreisz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramzi","family":"Sayegh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-7081","authenticated-orcid":false,"given":"Reinhard","family":"Told","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Baratsits","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Vienna Clinical Trial Center Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Baumann","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Pircher","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph K.","family":"Hitzenberger","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Sacu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"},{"name":"Department of Ophthalmology Vienna Clinical Trial Center Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7788-7311","authenticated-orcid":false,"given":"Ursula","family":"Schmidt\u2010Erfurth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.3499420"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.3.001670"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mam.2012.04.005"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2014.05.003"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2013.5799"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081499"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.08.029"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01778"},{"key":"e_1_2_5_10_1","first-page":"718","article-title":"In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics","volume":"36","author":"Delori FC","year":"1995","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_5_11_1","first-page":"583","article-title":"Lipofuscin and melanin of human retinal pigment epithelium. Fluorescence, enzyme cytochemical, and ultrastructural studies","volume":"17","author":"Feeney L","year":"1978","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1364\/OPEX.13.010217"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1364\/OE.16.016410"},{"key":"e_1_2_5_14_1","first-page":"267","article-title":"Phenotypic variation of retinal pigment epithelium in age\u2010related macular degeneration","volume":"43","author":"Guidry C","year":"2002","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001248"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(86)90535-0"},{"key":"e_1_2_5_17_1","first-page":"1986","article-title":"Quantifying changes in RPE and choroidal vasculature in eyes with age\u2010related macular degeneration","volume":"43","author":"McLeod DS","year":"2002","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.09-3639"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-03529-8"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001287"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6476"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-3209-8_36"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.05.041"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1589"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2011.06.003"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-11550"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.007"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0905010106"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1988.106"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.14-15114"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(89)32694-7"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-0892"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.11-7877"},{"key":"e_1_2_5_34_1","first-page":"25","article-title":"The natural history of geographic atrophy, the advanced atrophic form of age\u2010related macular degeneration","volume":"5","author":"Sunness JS","year":"1999","journal-title":"Mol Vis"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.07-1460"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.15-16431"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001276"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.3.002720"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faos.14352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.14352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aos.14352","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.14352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T09:52:33Z","timestamp":1693907553000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.14352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,17]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/aos.14352"],"URL":"https:\/\/doi.org\/10.1111\/aos.14352","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"type":"print","value":"1755-375X"},{"type":"electronic","value":"1755-3768"}],"subject":[],"published":{"date-parts":[[2020,2,17]]},"assertion":[{"value":"2018-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}