High-Resolution OCT of Basal Laminar Deposit Phenotypes and Retinal Pigment Epithelium Morphologic Changes in Age-Related Macular Degeneration

@article{albertoquarta2026highresolution,
  title = {{High-Resolution OCT of Basal Laminar Deposit Phenotypes and Retinal Pigment Epithelium Morphologic Changes in Age-Related Macular Degeneration}},
  author = {Alberto Quarta, MD and Shinichiro Chujo, MD, PhD and Paolo Forte, MD and Alessandro Feo, MD and Jianfeng Huang, MD and Rouzbeh Abbasgholizadeh, MD, FEBO and Federico Sivilotti, MD and Ceren Soylu, MD and Seungmin Lee, MD and Giulia Corradetti, MD and David Sarraf, MD and Srinivas R. Sadda, MD, FARVO},
  journal = {Ophthalmology Science},
  year = {2026},
  month = sep,
  doi = {10.1016/j.xops.2026.101415},
  url = {https://doi.org/10.1016/j.xops.2026.101415},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - High-Resolution OCT of Basal Laminar Deposit Phenotypes and Retinal Pigment Epithelium Morphologic Changes in Age-Related Macular Degeneration
AU  - Alberto Quarta, MD
AU  - Shinichiro Chujo, MD, PhD
AU  - Paolo Forte, MD
AU  - Alessandro Feo, MD
AU  - Jianfeng Huang, MD
AU  - Rouzbeh Abbasgholizadeh, MD, FEBO
AU  - Federico Sivilotti, MD
AU  - Ceren Soylu, MD
AU  - Seungmin Lee, MD
AU  - Giulia Corradetti, MD
AU  - David Sarraf, MD
AU  - Srinivas R. Sadda, MD, FARVO
PY  - 2026
DA  - 2026/09/23
JO  - Ophthalmology Science
DO  - 10.1016/j.xops.2026.101415
UR  - https://doi.org/10.1016/j.xops.2026.101415
AB  - Purpose: To characterize the high-resolution OCT phenotype of basal laminar deposit (BLamD) and the codistribution of retinal pigment epithelium (RPE) morphologic changes in patients with age-related macular degeneration (AMD). Design: Cross-sectional observational study. Participants: Thirty-one eyes from 19 patients (10 female, 9 male; mean age 85.6 ± 5.5 years) with AMD and OCT-visible BLamD. Methods: Structural high-resolution OCT B-scans were systematically graded for BLamD phenotype (persistent, scalloped, and outer retinal corrugations), RPE morphologic changes (spiky RPE and intraretinal hyperreflective foci [IHRF]), foveal involvement, and additional features (hypocore drusen, subretinal drusenoid deposits [SDDs], and soft drusen), including geographic atrophy (GA), complete RPE and outer retinal atrophy (cRORA), and incomplete RPE and outer retinal atrophy. Main Outcome Measures: Prevalence and co-occurrence of BLamD and RPE phenotypic features stratified by foveal status. Results: Of the 117 screened patients with AMD, 19 (16.2%) had OCT-visible BLamD, contributing 31 eyes: 28 with cRORA, 1 with incomplete RPE and outer retinal atrophy, and 2 without OCT-defined atrophy. Persistent BLamD was the most prevalent finding (28/31, 90.3%), followed by scalloped BLamD and IHRF (both 21/31, 67.7%) and spiky RPE (18/31, 58.1%). All 31 eyes exhibited ≥1 RPE–BLamD complex abnormality, and 27/31 eyes (87.1%) demonstrated ≥2 concurrent features. Outer retinal corrugations were identified in 4/31 eyes (12.9%) and were exclusively present in eyes without spiky RPE (4/13, 30.8% vs. 0/18, 0%). Foveal-spared GA eyes showed higher prevalences of spiky RPE (9/14, 64.3% vs. 6/14, 42.9%) and IHRF (11/14, 78.6% vs. 7/14, 50.0%) compared with foveal-involved eyes. Eyes lacking persistent BLamD (3/31, 9.7%) paradoxically showed all spiky RPE, scalloped BLamD, and IHRF. Additional findings included hypocore drusen in 8/31 eyes (25.8%), SDD in 31/31 eyes (100%), and soft drusen in 4/31 eyes (12.9%). Conclusions: In BLamD-associated GA, persistent and scalloped BLamD, spiky RPE, IHRF, and outer retinal corrugations showed variable patterns of co-occurrence. Spiky RPE and IHRF were more frequent in foveal-sparing than in foveal-involved eyes, although the significance of this observation requires longitudinal validation. These findings support the integration of BLamD morphologic subtyping and RPE phenotyping into clinical and trial-based assessments of advanced AMD, with potential implications for patient selection and monitoring in the era of approved complement inhibition therapies. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
SN  - 2666-9145
ER  -