Correlations between Choriocapillaris Flow Deficits around Geographic Atrophy and Enlargement Rates Based on Swept-Source OCT Imaging

Thulliez, Marie; Zhang, Qinqin; Shi, Yingying; Zhou, Hao; Chu, Zhongdi; Sisternes, Luís de; Durbin, Mary K; Feuer, William J.; Gregori, Giovanni; Wang, Ke; Rosenfeld, Philip J.

doi:10.1016/j.oret.2019.01.024

Cited by 101 publications

(67 citation statements)

References 39 publications

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“…Eyes with geographic atrophy had significantly higher choriocapillary flow deficits compared to either age-matched healthy control eyes or eyes with neovascular AMD in peripheral macular regions (Alagorie et al 2019). Increases in choriocapillary flow voids throughout the eye were also positively correlated with increases in geographic atrophy enlargement rate (Thulliez et al 2019), consistent with the idea that choriocapillaris defects contribute to the progression of geographic atrophy.…”

Section: Changes In the Choroid In Late Amdsupporting

confidence: 63%

Microvascular contributions to age-related macular degeneration (AMD): from mechanisms of choriocapillaris aging to novel interventions

et al. 2019

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Aging of the microcirculatory network plays a central role in the pathogenesis of a wide range of agerelated diseases, from heart failure to Alzheimer's disease. In the eye, changes in the choroid and choroidal microcirculation (choriocapillaris) also occur with age, and these changes can play a critical role in the pathogenesis of age-related macular degeneration (AMD). In order to develop novel treatments for amelioration of choriocapillaris aging and prevention of AMD, it is essential to understand the cellular and functional changes that occur in the choroid and choriocapillaris during aging. In this review, recent advances in in vivo analysis of choroidal structure and function in AMD patients and patients at risk for AMD are discussed. The pathophysiological roles of fundamental cellular and molecular mechanisms of aging including oxidative GeroScience

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Section: Changes In the Choroid In Late Amdsupporting

confidence: 63%

Microvascular contributions to age-related macular degeneration (AMD): from mechanisms of choriocapillaris aging to novel interventions

et al. 2019

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“…Our observed progression rates were similar to previously reported progression rates of RPE-atrophy. 20,38,49,50 In summary, this analysis demonstrates that presence of type 1 CNV is associated with reduced localized RPE-atrophy progression. While our data do not prove a causal relation, i.e., protection of RPE and photoreceptors by type 1 CNV, it certainly supports this hypothesis.…”

Section: Limitations and Strengthsmentioning

confidence: 72%

“…Type 1 CNV may enhance the interchange between the RPE and choroid by increasing the sub-RPE capillary density and thereby the sub-RPE blood flow to compensate for ChC breakdown as observed in histopathologic studies and in vivo by OCTA. 10,24,[34][35][36][37][38] In addition, type 1 CNV also obviates the interchange barrier due to an age-associated BrM change, which is characterized by an increased calcification of elastic fibers and accumulation of lipid rich extracellular deposits between the RPE basal lamina and the inner collagenous layer of BrM including basal linear deposits (BLinD) and soft drusen. [11][12][13][39][40][41][42] Potential therapeutic implications…”

Section: Discussionmentioning

confidence: 99%

Type 1 Choroidal Neovascularization Is Associated with Reduced Localized Progression of Atrophy in Age-Related Macular Degeneration

Pfau

Möller

Künzel

et al. 2020

Ophthalmology Retina

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“… 24 , 25 An ultrastructural study by Biesemeier et al, however, found CC loss beyond the border of RPE atrophy. 26 Recent OCTA studies suggest that there is loss of CC beyond the area of RPE atrophy in STGD 16 and geographic atrophy, 27 – 29 which they call flow deficits. However, it is not known if flow deficits represent actual CC loss, as measured herein, or simply a decrease in blood flow in those areas.…”

Section: Discussionmentioning

confidence: 99%

Retinal Glial and Choroidal Vascular Pathology in Donors Clinically Diagnosed With Stargardt Disease

Edwards

Bonilha

Bhutto

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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The present study investigated retinal glia and choroidal vessels in flatmounts and sections from individuals with clinically diagnosed Stargardt disease (STGD). METHODS. Eyes from three donors clinically diagnosed with STGD were obtained through the Foundation Fighting Blindness (FFB). Genetic testing was performed to determine the disease-causing mutations. Eyes were enucleated and fixed in 4% paraformaldehyde and 0.5% glutaraldehyde. After imaging, retinas were dissected and immunostained for glial fibrillary acidic protein, vimentin, and peanut agglutin. Following RPE removal, the choroid was immunostained with Ulex europaeus agglutinin lectin. For each choroid, the area of affected vasculature, percent vascular area, and choriocapillaris luminal diameters were measured. The retina from one donor was hemisected and cryopreserved or embedded in JB-4 for cross-section analysis. RESULTS. Genetic testing confirmed the STGD diagnosis in donor 1, whereas a mutation in peripherin 2 was identified in donor 3. Genetic testing was not successful on donor 2. Therefore, only donor 1 can definitively be classified as having STGD. All donors had areas of RPE atrophy within the macular region, which correlated with underlying choriocapillaris loss. In addition, Müller cells formed pre-and subretinal membranes. Subretinal gliotic membranes correlated almost identically with RPE and choriocapillaris loss. CONCLUSIONS. Despite bearing different genetic mutations, all donors demonstrated choriocapillaris loss and Müller cell membranes correlating with RPE loss. Müller cell remodeling was most extensive in the donor with the peripherin mutation, whereas choriocapillaris loss was greatest in the confirmed STGD donor. This study emphasizes the importance of genetic testing when diagnosing macular disease.

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Correlations between Choriocapillaris Flow Deficits around Geographic Atrophy and Enlargement Rates Based on Swept-Source OCT Imaging

Cited by 101 publications

References 39 publications

Microvascular contributions to age-related macular degeneration (AMD): from mechanisms of choriocapillaris aging to novel interventions

Microvascular contributions to age-related macular degeneration (AMD): from mechanisms of choriocapillaris aging to novel interventions

Type 1 Choroidal Neovascularization Is Associated with Reduced Localized Progression of Atrophy in Age-Related Macular Degeneration

Retinal Glial and Choroidal Vascular Pathology in Donors Clinically Diagnosed With Stargardt Disease

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