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Florence Coscas, Nathalie Puche, Gabriel Coscas, Catherine Francais, Mayer Srour, Gerard Mimoun, Giuseppe Querques, Eric Souied; Choroidal Thickness in Adult Onset Foveomacular Vittelliform Dystrophy and in Exudative Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4856.
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To compare choroidal thickness between eyes with adult onset foveo macular vitelliform dystrophy (AOFVD) and eyes with age-related macular degeneration (AMD).
Design: Observational, comparative case series. Participants: Twenty-five eyes with AOFVD, 25 fellow eyes with AOFVD, 40 eyes with exudative AMD without FV-PED,40 eyes with dry AMD, and 20 eyes of age-matched normal subjects. Choroidal thickness was measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) with Spectralis, Heidelberg Engineering, Heidelberg, Germany). Subfoveal choroidal thickness in each eye was analyzed with measurement of the vertical distance from the Bruch’s membrane to the innermost choroid/sclera junction, at 500µm intervals up to 1500µm, from temporal to nasal and from superior to inferior to the center of the fovea, and were evaluated in all eyes. All measurements were performed by 2 independent and trained observers.
The difference between subfoveal CT AOFVD with pseudo DSR (384.1 + -93.4 µm) versus CT in exudative AMD without detachment of the pigment epithelium fibro vascular (192.33 + -77.36 microns) and CT in atrophic AMD (162, 06 + -63, 6 µm) are statistically significant, respectively p <0.003 and p <0.0001). The difference found between the CT of the affected eye and the fellow eye in AOFVD (395 + - 92.91 microns) is not statistically significant (p = 0.8) Choroidal thickness at each of the other 12 points showed a similar tendency.
This study demonstrates thickening of choroid in the eyes with AOFVD, in contrast with choroidal thinning observed in eyes with AMD. These findings suggest involvement of different pathogenic mechanisms in AOFVD from those in exudative AMD. Choroidal thickness measurement could become criteria for diagnosis between exudative AMD and advanced stage of AOFVD with fluid accumulation and for any eventual decision of treatment with indication for anti VEGF IVT.
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