Abstract
Choroid thinning occurs in age-related macular degeneration (AMD). However, it remains unclear whether the reduction is due to reduction in choroidal vessels or shrinkage of choroidal stroma, or both. The purpose of this study was to evaluate the changes of the choroidal vascular and stromal area in 118 patients with typical AMD (t-AMD) and polypoidal choroidal vasculopathy (PCV) over a 12-month period. We used spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode to measure the subfoveal choroidal thickness (CT), central retinal thickness (CRT) and choroidal vascularity index (CVI - ratio of luminal area to total choroidal area). At baseline, PCV eyes had higher CRT (471.6 µm vs 439.1 µm, p = 0.02), but comparable subfoveal CT and CVI, compared to t-AMD. Eyes with high CVI at baseline showed marked reduction in stromal area compared with eyes with average or low CVI. Over 12 months, CRT and subfoveal CT significantly decreased (p < 0.001) in both subtypes. Eyes with high baseline CVI showed significant CVI reduction from baseline to month 12 (p < 0.001), whereas eyes with average to low baseline CVI showed increase in CVI. These differences in choroidal vascularity may reflect different predominant pathogenic processes and remodeling in AMD eyes with varying spectrum.
Highlights
Choroid thinning occurs in age-related macular degeneration (AMD)
There was no difference in terms of age, gender, smoking status, spherical equivalence, best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness, choroidal vascularity index (CVI), total choroid area (TCA), Luminal area (LA) and Stromal Area (SA) between AMD and polypoidal choroidal vasculopathy (PCV) eyes (Table 1)
There was a significant reduction in mean subfoveal choroidal thickness (CT) from baseline to month 12 in both typical AMD (t-AMD) and PCV groups
Summary
Choroid thinning occurs in age-related macular degeneration (AMD) It remains unclear whether the reduction is due to reduction in choroidal vessels or shrinkage of choroidal stroma, or both. An eye with pachychoroid may have normal or reduced choroidal thickness with dilated choroidal vessels and atrophy of choriocapillary layer[8] This description, remains largely descriptive and is subjected to variations in individual interpretation. Address this gap, the purpose of this study is to evaluate the changes of the choroidal vascular and stromal area in patients with t-AMD and PCV over a 12-month period, after receiving treatment. We hypothesize that there is a possible choroidal remodeling in eyes with t-AMD and PCV, CVI would decrease in association with CT if there is preferential loss of choroidal vasculature, and that eyes with pachychoroid features (showing high baseline CVI) may exhibit a more marked reduction in CVI
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