Progression of cRORA (Complete RPE and Outer Retinal Atrophy) in Dry Age-Related Macular Degeneration Measured Using SD-OCT

Or Shmueli, Roei Yehuda, Adi Szeskin, Leo Joskowicz, Jaime Levy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


PURPOSE: The purpose of this study was to evaluate the long-term rate of progression and baseline predictors of geographic atrophy (GA) using complete retinal pigment epithelium and outer retinal atrophy (cRORA) annotation criteria.

METHODS: This is a retrospective study. Columns of GA were manually annotated by two graders using a self-developed software on optical coherence tomography (OCT) B-scans and projected onto the infrared images. The primary outcomes were: (1) rate of area progression, (2) rate of square root area progression, and (3) rate of radial progression towards the fovea. The effects of 11 additional baseline predictors on the primary outcomes were analyzed: total area, focality (defined as the number of lesions whose area is >0.05 mm2), circularity, total lesion perimeter, minimum diameter, maximum diameter, minimum distance from the center, sex, age, presence/absence of hypertension, and lens status.

RESULTS: GA was annotated in 33 pairs of baseline and follow-up OCT scans from 33 eyes of 18 patients with dry age-related macular degeneration (AMD) followed for at least 6 months. The mean rate of area progression was 1.49 ± 0.86 mm2/year (P < 0.0001 vs. baseline), and the mean rate of square root area progression was 0.33 ± 0.15 mm/year (P < 0.0001 vs. baseline). The mean rate of radial progression toward the fovea was 0.07 ± 0.11 mm/year. A multiple variable linear regression model (adjusted r2 = 0.522) revealed that baseline focality and female sex were significantly correlated with the rate of GA area progression.

CONCLUSIONS: GA area progression was quantified using OCT as an alternative to conventional measurements performed on fundus autofluorescence images. Baseline focality correlated with GA area progression rate and lesion's minimal distance from the center correlated with GA radial progression rate toward the center. These may be important markers for the assessment of GA activity.

TRANSLATIONAL RELEVANCE: Advanced method linking specific retinal micro-anatomy to GA area progression analysis.

Original languageAmerican English
Article number19
JournalTranslational Vision Science and Technology
Issue number1
StatePublished - Jan 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors.


  • OCT scan analysis
  • age-related macular degeneration
  • complete retinal pigment epithelium (RPE) and outer retinal atrophy
  • retinal atrophy progression


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