Correlation between Visual Acuity and OCT Biomarkers in Patients with Neovascular AMD

Abstract

Background: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss among older adults. Optical coherence tomography (OCT) enables detailed assessment of retinal morphology and provides valuable biomarkers that may correlate with visual function. Identifying structural predictors of visual acuity is essential for prognosis and treatment planning.

Methods: A hospital-based observational cross-sectional analytical study was conducted on 62 eyes diagnosed with neovascular AMD. Demographic and clinical data were recorded, and all patients underwent comprehensive ophthalmic examination, including best-corrected visual acuity (BCVA) assessment and spectral-domain OCT imaging. OCT biomarkers evaluated included central retinal thickness (CRT), intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), hyperreflective foci (HRF), subretinal hyperreflective material (SHRM), ellipsoid zone (EZ) disruption, and external limiting membrane (ELM) disruption. Correlation and multivariable regression analyses were performed using SPSS, with p < 0.05 considered statistically significant.

Results: The mean age of the participants was 68.5 ± 8.2 years, and 58.1% were males. The mean BCVA was 0.82 ± 0.32 logMAR. IRF (64.5%), SRF (58.1%), and EZ disruption (54.8%) were the most common OCT biomarkers. Poorer BCVA showed significant positive correlations with CRT (r = 0.41), IRF (r = 0.48), PED (r = 0.32), HRF (r = 0.37), SHRM (r =0.44), EZ disruption (r = 0.56), and ELM disruption (r = 0.52) (all p < 0.05). Multiple regression analysis identified EZ disruption (β = 0.36) as the strongest independent predictor of poor visual acuity, followed by IRF, SHRM, CRT, and age.

Conclusion: OCT biomarkers demonstrated significant associations with visual acuity in patients with neovascular AMD. Among these, ellipsoid zone disruption, external limiting membrane disruption, and intraretinal fluid were the strongest predictors of visual impairment. Comprehensive OCT biomarker evaluation may improve prognostic assessment and support individualized management of neovascular AMD.