Second Reflective Band Intensity in Age-related Macular Degeneration

Further characterization of the anatomic changes present in early age-related macular degeneration (AMD) will lead to improved markers of disease severity and progression. Currently, spectral-domain optical coherence tomography (SD-OCT) allows the delineation of 3 to 4 reflective bands in the outer retina. The second hyperreflective band is of particular interest owing to its close correlation with visual function and prognostic implications in different retinal diseases. The second hyperreflective band has been suggested to correspond anatomically to the ellipsoids of the photoreceptor inner segments (ISe), and has been shown recently to diminish in intensity in patients with little or no cone function. Given that a strong association exists between AMD and the ARMS2 (age-related maculopathy susceptibility 2) gene, which encodes a mitochondrial protein within the inner segment ellipsoids, we sought to determine the intensity of the ISe band in patients with early AMD using a novel, quantitative method of analysis. The Human Research and Ethics Committee of the Royal Victorian Eye and Ear Hospital approved this study.