Abstract
Age-related macular degeneration (AMD) is a major cause of vision loss in the developed world and its pathogenesis is a topic of active research. To date, much study has been focused on the role of the retinal pigment epithelium (RPE) and Bruch's membrane (BrM) in AMD pathogenesis, but the role of the choroid has also been investigated. In this review, we focus on recent advancements in research in the role of the choroid in AMD, beginning with an exploration of the histopathologic, cellular and molecular changes that occur in the choroid in AMD and concluding by discussing new choroidal imaging techniques and patterns seen on fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography and optical coherence tomography angiography. Exploring these domains will lead to a better understanding of the factors at play beyond the outer retina in this important disease.
Highlights
Age‐related macular degeneration (AMD) is a progressive, sight‐threatening disease and the major cause of permanent vision loss among elderly people in the developed world.[1]
Atrophy of light sensitive cells including the retinal pigment epithelium (RPE), outer retina and supporting tissue on the central retinal area resulting in geographic atrophy (GA), or choroidal neovascularization (CNV), the presence of abnormal and fragile blood vessels in the sub‐RPE or sub‐retinal space in neovascular AMD (NVAMD), are considered the advanced form of AMD, Age‐Related Eye Disease Study (AREDS) category 4.[11]. Progression from early to late AMD is associated with severe and irreversible vision loss
OCT angiography (OCTA) has allowed for better visualization of choroidal morphology in AMD and has further corroborated the choroidal attenuation seen on histopathology and spectral domain OCT (SD‐OCT)
Summary
Age‐related macular degeneration (AMD) is a progressive, sight‐threatening disease and the major cause of permanent vision loss among elderly people in the developed world.[1]. We will focus on new advancements in research in the role of the choroid in the pathogenesis of AMD, beginning with an exploration of the histopathologic, cellular and molecular changes that occur throughout the natural history and concluding by. Understanding the classification and histopathologic characteristics of AMD, as well as the function and anatomy of the choroid, will give us a better insight into the pathologic changes that occur in the choroid throughout the course of the disease
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