ASSOCIATION BETWEEN PREDIAGNOSTIC MACULAR THICKNESS WITH RISK OF AGE-RELATED MACULAR DEGENERATION.

<h4>Purpose</h4>To determine whether specific prediagnostic macular thickness are associated with an increased risk of age-related macular degeneration (AMD).<h4>Methods</h4>A total of 40,078 UK Biobank participants without baseline AMD who underwent optical coherence tomography imaging were included. Macular thickness measurements were obtained through optical coherence tomography across nine subfields of the Early Treatment Diabetic Retinopathy Study. Latent Profile Analysis was used to classify distinct prediagnostic macular thickness profiles, while cox proportional hazards models were used to estimate hazard ratios between the identified profiles.<h4>Results</h4>Two distinct prediagnostic macular thickness profiles were identified. Compared with Profile 1 (n = 31,942), Profile 2 (n = 8,136) was characterized by thinner inner and outer superior subfields, alongside thicker central and other outer subfields. Profile 2 was associated with significantly increased AMD risk compared with Profile 1 (hazard ratio, 1.59; 95% confidence interval, 1.32-1.90; P < 0.001). After adjustment for all covariates, the observed association persisted (hazard ratio, 1.39; 95% confidence interval, 1.16-1.67; P < 0.001).<h4>Conclusion</h4>Distinct prediagnostic macular thickness patterns are associated with elevated AMD risk. These findings provide novel insights into potential early macular structural changes before AMD diagnosis, and may serve as novel biomarkers for early identification of AMD.