Choroidal structural changes in different intermediate AMD patterns

Viggiano, Pasquale; Toto, Lisa; Ferro, Giada; Evangelista, Federica; Porreca, Annamaria; Mastropasqua, Rodolfo

doi:10.1177/1120672121992009

Cited by 21 publications

(18 citation statements)

References 41 publications

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“…CVI reduction in RPDs/SDDs was further confirmed in a recent study, where the eyes with drusen greater than 125 μm did not show significant changes compared with healthy controls [ 120 ]. CVI changes in AMD seem to follow a biphasic trend, with an initial increase during the earlier stages of AMD, followed by a progressive decrease in the advanced stages.…”

Section: Choroidal Imaging and Assessment In Vivomentioning

confidence: 54%

Choroidal Vasculature Changes in Age-Related Macular Degeneration: From a Molecular to a Clinical Perspective

Fragiotta¹,

Scuderi

Iodice³

et al. 2022

IJMS

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The contribution of choroidal vasculature to the pathogenesis of age-related macular degeneration (AMD) has been long debated. The present narrative review aims to discuss the primary molecular and choroidal structural changes occurring with aging and AMD with a brief overview of the principal multimodal imaging modalities and techniques that enable the optimal in vivo visualization of choroidal modifications. The molecular aspects that target the choroid in AMD mainly involve human leukocyte antigen (HLA) expression, complement dysregulation, leukocyte interaction at Bruch’s membrane, and mast cell infiltration of the choroid. A mechanistic link between high-risk genetic loci for AMD and mast cell recruitment has also been recently demonstrated. Recent advances in multimodal imaging allow more detailed visualization of choroidal structure, identifying alterations that may expand our comprehension of aging and AMD development.

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Section: Choroidal Imaging and Assessment In Vivomentioning

confidence: 54%

Choroidal Vasculature Changes in Age-Related Macular Degeneration: From a Molecular to a Clinical Perspective

Fragiotta¹,

Scuderi

Iodice³

et al. 2022

IJMS

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“…Structural optical coherence tomography (OCT) has provided the capability to provide metrics reflecting the retinal and choroidal anatomy (e.g., central retinal thickness [ 13 ], choroidal vascularity index [ 14 ], and subfoveal choroidal thickness [ 15 ]). Accordingly, structural OCT has been employed to observe and quantify the effect of intravitreal anti-VEGF therapy in neovascular AMD.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Morphofunctional Changes in Previously Treated Neovascular AMD Eyes Switched to Brolucizumab

Viggiano

Grassi

Boscia

et al. 2022

JCM

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The purpose of the study is to explore the morphofunctional fluctuations in eyes treated for neovascular AMD (nAMD) when treatment is switched from aflibercept or ranibizumab to brolucizumab. A total of 31 eyes of 31 patients with nAMD with type 1 macular neovascularization (MNV) were included. All patients were imaged using spectral domain optical coherence tomography (SD-OCT). The OCT acquisition was performed at the following visits: (i) “T1 visit” corresponding to the last follow-up examination in which an intravitreal injection of aflibercept or ranibizumab was performed before switching to brolucizumab because of the lack of improvement and (ii) “T2 visit” corresponding to the examination performed 1 month after T1, the latter visit corresponding to the day when a switch to brolucizumab injection was performed, (iii) and 1 month after the latter injection “(T3)”. The main outcome measures were: (1) central macular thickness (CMT), (2) choroidal vascularity index (CVI), (3) subfoveal choroidal thickness (CT), and best-corrected visual acuity (BCVA). Functional outcome showed significant differences at each time. Mean ± SD BCVA was 0.43 ± 0.12 LogMAR at T1 and 0.56 ± 0.16 LogMAR at T2 (p = 0.038). A significant improvement in BCVA was displayed at T3 (0.34 ± 0.21 LogMAR) as compared with T2 (p = 0.019). CMT analysis showed fluctuations three times. In detail, T2 displayed a thicker CMT in comparison with T1, although not statistically significant (p = 0.12). Contrariwise, T3 showed a thinner CMT in comparison with T2 (p = 0.002). Analyzing CVI among the three different times, the luminal choroidal area (LCA) and total choroidal area (TCA) showed significantly different values before and after switching to brolucizumab. T2 showed a significant reduction in both vessel lumen and total area compared with T1 (p = 0.032 and p = 0.046, respectively). Moreover, T3 showed a greater value of both LCA and TCA in comparison with T2 (p = 0.008 and p = 0.01, respectively). CT did not show significant differences at each time (p > 0.05). Our results reported early experiences on morphofunctional fluctuations in patients with nAMD who switched to brolucizumab. The anatomical impact of brolucizumab administration appears to result in choroidal vascular enlargement, accompanied by the resolution of subretinal fluid (SRF) and intraretinal fluid (IRF).

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“… 37 This observation is supported by the findings from one recent study reporting a lack of a significant difference in CVI between eyes with only RPD compared to eyes with large drusen. 38 Another study reported that the CVI was higher in non-neovascular AMD eyes with RPD compared to those without. 36 In that study, eyes with RPD also had a significantly lower luminal area (or extent of choroidal vessels) but did not have a significantly lower choroidal thickness.…”

Section: Discussionmentioning

confidence: 99%

“… 37 One study recently observed a significant difference in CVI between eyes with and without RPD, 36 but another study did not observe any significant differences. 38 …”

mentioning

confidence: 99%

Impact of Reticular Pseudodrusen on Choriocapillaris Flow Deficits and Choroidal Structure on Optical Coherence Tomography Angiography

Zhou

Chu

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose To examine the impact of reticular pseudodrusen (RPD) on choriocapillaris blood flow and choroidal structure in individuals with intermediate age-related macular degeneration (AMD). Methods Individuals with bilateral large drusen underwent optical coherence tomography (OCT), color fundus photography, near-infrared reflectance, and fundus autofluorescence imaging to determine the presence of RPD. These participants also underwent swept-source OCT angiography (SS-OCTA) imaging to determine (1) choriocapillaris flow deficit (FD) parameters, including the percentage, mean size, and number of FDs present; and (2) choroidal structural parameters, including mean choroidal thickness and choroidal vascularity index. Differences in these parameters between eyes with and without coexistent RPD were examined with and without adjustment for potential key confounders such as drusen volume from the SS-OCTA scans and age. Results This study included 102 eyes from 51 individuals with bilateral large drusen, and the analyses showed that there were no significant differences in the choriocapillaris FD parameters ( P ≥ 0.062 for all) and choroidal structural parameters ( P ≥ 0.059 for all), with or without adjustment for potential confounders in this cohort. However, the percentage of FDs and the mean FD size were both significantly greater with increasing drusen volume ( P ≤ 0.038 for both). Conclusions The coexistence of RPD in eyes of individuals with intermediate AMD was not associated with significant impairments in choriocapillaris blood flow and choroidal vascular structural changes, with or without adjustment for key confounders. These findings suggest that macular changes in these vascular parameters may not be associated with the presence of RPD.

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Choroidal structural changes in different intermediate AMD patterns

Cited by 21 publications

References 41 publications

Choroidal Vasculature Changes in Age-Related Macular Degeneration: From a Molecular to a Clinical Perspective

Choroidal Vasculature Changes in Age-Related Macular Degeneration: From a Molecular to a Clinical Perspective

Short-Term Morphofunctional Changes in Previously Treated Neovascular AMD Eyes Switched to Brolucizumab

Impact of Reticular Pseudodrusen on Choriocapillaris Flow Deficits and Choroidal Structure on Optical Coherence Tomography Angiography

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