Longitudinal choriocapillaris changes in the presence of reticular pseudodrusen

Abstract

To determine longitudinal changes in choriocapillaris (CC) measures in eyes with reticular pseudodrusen (RPD) using optical coherence tomography angiography (OCTA). In this observational prospective study, 20 patients with exclusively RPD and no other alteration due to age-related macular degeneration were included. Eight RPD patients were re-examined at 5-year follow-up. Multimodal imaging was performed at baseline and at 5-year follow-up. OCTA CC images were analyzed for number, size and total area of flow deficits (FD), mean signal intensity, signal intensity standard deviation and kurtosis of signal intensity distribution in the ring area between a circle of 4 mm diameter and a circle of 6 mm diameter and in the superior ring quadrant. Area affected by RPD increased from 19.36 ± 8.39 mm2 at baseline to 37.77 ± 9.03 mm2 at 5-year follow-up. At baseline, percent of CC FD area was greater in RPD eyes (quadrant: p < 0.001; ring: p < 0.001) compared to controls. Besides, RPD eyes revealed a lower mean intensity signal (quadrant: p < 0.001; ring: p < 0.001). Evaluation of CC parameters suggested significant group × time interaction effects for CC FD (p = 0.04) and mean intensity signal (p = 0.004), in that RPD eyes presented increased CC FD and decreased mean intensity signal at follow-up. OCTA CC decorrelation signal further decreases in RPD patients over 5 years in both RPD-affected and RPD-unaffected macular areas.

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

“…Likewise, choroidal thinning is a characteristic in eyes with RPDs/SDDs and geographic atrophy [ 68 , 102 , 103 , 104 ]. Several in vivo studies confirmed a marked alteration in choroidal parameters in eyes with RPDs/SDDs, using choroidal thickness, choroidal vascular thickness, choroidal vascularity index (CVI), and optical coherence tomography angiography (OCTA) [ 105 , 106 , 107 , 108 , 109 , 110 ]. Although most of the existing literature reported a thinner choroid in eyes with SDDs, some studies did not observe choroidal thinning between AMD eyes and SDDs, suggesting a non-univocal association between SDDs and choroidal thickness [ 84 , 85 ].…”

Choriocapillaris Impairment Is Associated With Delayed Rod-Mediated Dark Adaptation in Age-Related Macular Degeneration

“…Previous research indicated that eyes with SDD have reduced visual acuity and greater choriocapillaris impairment, compared to eyes with drusen and lacking SDD. 17 , 18 A 5-year longitudinal study showed that both SDD-affected and unaffected areas can be associated with choriocapillaris impairment. 17 …”

“… 17 , 18 A 5-year longitudinal study showed that both SDD-affected and unaffected areas can be associated with choriocapillaris impairment. 17 …”

“… 14 Further, choriocapillaris flow deficits are associated with the presence of drusen 15 , 16 and subretinal drusenoid deposits (SDD). 17 , 18 Repeatable quantification of choriocapillaris is achievable with advancements in scan speed, signal compensation, projection artifact removal, and analytical tools. 19 This enables new insights into the role of vascular dysfunction in the natural history of aging to the emergence of AMD.…”

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

“… 22 It is also in contrast to previous observations that eyes with RPD had a larger proportion of the total FD area accounted for by FDs ≥ 10,000 µm 2 in one study, 54 or more individual areas of larger FDs in another study. 55 These differences may be attributed to differences in CC flow impairments between eyes with large drusen and coexistent RPD and eyes with only RPD.…”