Relationship Between Presumptive Inner Nuclear Layer Thickness and Geographic Atrophy Progression in Age-Related Macular Degeneration

Ebneter, Andreas; Jaggi, Damian; Abegg, Mathias; Wolf, Sebastian; Zinkernagel, Martin (2016). Relationship Between Presumptive Inner Nuclear Layer Thickness and Geographic Atrophy Progression in Age-Related Macular Degeneration. Investigative ophthalmology & visual science, 57(9), OCT299-306. Association for Research in Vision and Ophthalmology 10.1167/iovs.15-18865

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PURPOSE To analyze inner retinal changes in patients with geographic atrophy (GA) secondary to age-related macular degeneration and identify morphological cues for progression. METHODS A total of 100 eyes with GA were assessed in this longitudinal, observational case series. Patients with GA and absent confounding pathology were compared with age-matched controls. The retinal layers on spectral-domain optical coherence tomography, acquired in tracking mode, were segmented manually on central scans through the fixation point. Zones of GA were defined based on choroidal signal enhancement from retinal pigment epithelium loss. An area of unaffected temporal retina was used for comparison. Progression of GA was quantified with fundus autofluorescence. RESULTS We analyzed 41 eyes of 41 patients (mean age 79.2 ± 6.7 years). In areas of GA, the layer representing the inner nuclear layer (INL) in healthy retina was increased in thickness. Thickness of this presumptive INL was inversely correlated with best-corrected visual acuity (r = -0.48, P < 0.01). The presumptive INL thickness increase in atrophic areas was less marked in eyes with foveal sparing. Increased INL thickness in areas adjacent to GA was associated with a higher progression rate. CONCLUSIONS Optical coherence tomography findings demonstrate that atrophy of the retinal pigment epithelium-photoreceptor complex in GA is associated with an increase of thickness of the presumptive INL, presumably caused by remodeling of the degenerating retina. Similar alterations in the retina adjacent to areas clinically affected by GA were associated with higher atrophy progression rates.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Ebneter, Andreas; Abegg, Mathias; Wolf, Sebastian and Zinkernagel, Martin


600 Technology > 610 Medicine & health




Association for Research in Vision and Ophthalmology




Sebastian Wolf

Date Deposited:

29 Aug 2016 10:50

Last Modified:

29 Aug 2016 15:14

Publisher DOI:


PubMed ID:





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