The impact of vascular risk factors on the thickness and volume of the choroid in AMD patients

Abstract

Disturbances in choroidal microcirculation may lead to the onset and progression of age-related macular degeneration (AMD). We aimed to assess changes in the choroidal volume and thickness in the macular region in AMD eyes and to investigate whether coexisting vascular risk factors alter choroidal status. We enrolled 354 AMD patients (175 dry, 179 wet AMD) and 121 healthy controls. All participants underwent a complete ophthalmologic examination and assessment of choroidal thickness and volume. A multivariate analysis adjusted for age, sex, and smoking status revealed that wet AMD was an independent factor associated with higher average thickness of the central ring area (ATC) and average volume of the central ring area (AVC) and lower choroidal vascularity index (CVI) compared to controls (β = + 0.18, p = 0.0007, β = + 0.18, p = 0.0008, respectively) and to dry AMD (β = + 0.17, p = 0.00003 for both ATC and AVC and β = − 0.30 p < 0.0001 for CVI). ATC, AVC and average volume (AV) were lower in AMD patients with hypertension and ischaemic heart disease (IHD). The duration of hypertension was inversely correlated with ATC, AVC and AV (Rs = − 0.13, p < 0.05; Rs = − 0.12; p < 0.05, Rs = − 0.12; p < 0.05, respectively) while IHD duration negatively correlated with AV (Rs = − 0.15, p < 0.05). No such associations were observed in the control group. Our findings show that the choroidal vascular system in eyes with AMD is much more susceptible to damage in the presence than in the absence of systemic vascular disease.

Choroidal Changes in Rhesus Macaques in Aging and Age-Related Drusen

“… 66 , 67 The choroid also appears thicker in eyes with CNV, 68 , 69 although choroidal vascularity is reduced in both nonexudative and exudative AMD, presumably attributed to increased inflammatory infiltrates in the choroid stroma. 70 Unlike human AMD, macaques with drusen do not exhibit reticular pseudodrusen and do not progress to CNV or GA. NHP drusen also do not demonstrate hyperreflective foci, hyporeflective cores, drusen substructures, or other OCT biomarkers or predictors of GA progression in humans. 71 – 74 Although soft drusen in macaques resemble those in patients with AMD in anatomy and molecular composition, the overlying RPE and photoreceptors do not show degenerative changes on histology or quantitative autofluorescence.…”

Outer Retinal Thickness Is Associated With Cognitive Function in Normal Aging to Intermediate Age-Related Macular Degeneration

“… 59 Regarding macro vessels in the eye, choroidal vascularity (proportion of choroid that is vascular cross-sections) but not thickness differed significantly between aged normal and dry AMD eyes ( n = 121 and 175, respectively). 60 …”

Association between Subretinal Drusenoid Deposits and Age-Related Macular Degeneration in Multimodal Retinal Imaging

“…Finally, each participant completed the International Physical Activity Questionnaire (IPAQ), consisting of seven questions about all types of physical activity (lasting at least 10 min) in the previous week. Physical activity scores are presented as MET min per week and calculated as previously described [27].…”