Choroidal Angioarchitecture According to Ultra-Widefield Indocyanine Green Angiography in Age-Related Macular Degeneration

Abstract

Purpose: To examine choroidal blood flow using ultra-widefield indocyanine green angiography (ICGA) in patients with age-related macular degeneration (AMD) and to compare these characteristics with those in normal controls. Methods: We reviewed the findings of ultra-widefield ICGA in patients with AMD and age-matched normal controls for comparison between April 2016 and November 2016. The primary outcome measure was the comparison of the vascular patterns of the choroid in the venous phase. The secondary outcome was abnormalities of the arterioles or venules in the macula in each group. Results: The study included 113 eyes of 84 patients with AMD (26 eyes with nonneovascular AMD, 58 eyes with typical AMD, and 29 eyes with polypoidal choroidal vasculopathy), 50 fellow eyes without the clinical characteristics of AMD, and 27 eyes of 24 age-matched normal controls. Patients with AMD were more likely than normal controls to have the region of greater hyperfluorescence of the ICGA with asymmetry of choroidal vasculature or abnormality of the vessels in the macula. Abnormalities of the vessels in the macula could be classified into 3 types: a small vortex vein, anastomosis between the choroidal veins, and the large choroidal vessels. Conclusions: Using ultra-widefield ICGA, we found that having an asymmetry of choroidal venules or abnormality of the vessels in the macula may be a predictive risk factor for the development or progression of AMD. These findings also support the association of alterations in choroidal hemodynamics with the pathogenesis of AMD.