Variation of Retinal and Choroidal Vasculatures in Patients With Age-Related Macular Degeneration

Abstract

PURPOSE. To investigate variations in chorioretinal vasculatures in fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD). METHODS. We included fellow eyes of consecutive patients with unilateral nAMD from swept source optical coherence tomography (SS-OCT) angiography database. Vascular and nonvascular indices were determined based on SS-OCT and SS-OCT angiography images. Variation of the vascular or nonvascular index was compared between fellow eyes with and without early AMD. RESULTS. In 146 fellow eyes, 88 (60.3%) had early AMD and 58 (39.7%) had a normal fundus. Vascular density (VD) values of the superficial and deep retinal capillary plexus and choriocapillaris were smaller in eyes with early AMD than in those without (P < 0.001, P ¼ 0.001, P ¼ 0.006, respectively). Flow void area in choriocapillaris was greater in eyes with early AMD than those without (P ¼ 0.015). In 88 fellow eyes with early AMD, vascular indices of the retina were correlated with those of choroid while nonvascular indices were not. Fellow eyes of patients with classic exudative AMD had greater foveal avascular zone area and smaller VD values of the deep retinal capillary plexus than those with polypoidal choroidal vasculopathy (P < 0.001, P ¼ 0.004). CONCLUSIONS. In addition to vascular insufficiency in the choroid or choriocapillaris, retinal vascular alteration was apparent in eyes with early AMD. It may suggest that retinal vessels were involved in the pathogenesis of AMD even while changes in nonvascular components of the retina were not yet apparent.

Vascular Changes in Intermediate Age-Related Macular Degeneration Quantified Using Optical Coherence Tomography Angiography

“…Choriocapillaris loss is associated also with AMD lesions, drusen, reticular pseudodrusen, and retinal pigment epithelium (RPE) atrophy 2,4,7. More recent work using optical coherence tomography angiography (OCTA) has found decreased choroidal vessel density in the early stages of AMD8–11 and subclinical choroidal neovascularization (CNV) lesions in intermediate AMD, not detectable with fluorescein angiography 12…”

Reduced Vessel Density of the Choriocapillaris during Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration

“…However, it should not play a role when the changes in the same eye are investigated. Furthermore, although a correlation between the SCP and DCP had been reported in normal eyes and early AMD, 51,52 which may possibly affect the statistical results, we did not consider this issue in the statistical analysis in the current study.…”

Characteristics of the inner retinal layer in the fellow eyes of patients with unilateral exudative age-related macular degeneration

“…They speculated that SDD was associated with choroidal hypoperfusion [42,43], which may have induced GC-IPL thinning. In addition, a previous study reported that microvascular perfusion as observed using OCT angiography was decreased further in the fellow eyes of unilateral classic AMD patients compared to unilateral PCV patients [44]. Soft drusen and SDD are uncommon in both unilateral PCV patients and their fellow eyes [45,46].…”

“…Soft drusen and SDD are uncommon in both unilateral PCV patients and their fellow eyes [45,46]. Although outer retinal and choroidal abnormalities are commonly found in the fellow eyes of PCV patients [44], their effects on the inner retinal layer are thought to be minimal. Based on these observations, it is assumed that the presence of soft drusen and SDD is an important variable affecting the inner retinal layer.…”