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Raquel Goldhardt, Carlos Alexandre A. Garcia Filho, Zohar Yehoshua, Giovanni Gregori, William Feuer, Philip J. Rosenfeld; Correlation Between Choroidal Thickness At Baseline And Disease Progression In Eyes With Dry AMD: The COMPLETE Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2048.
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To investigate the correlation between subfoveal choroidal thickness, baseline characteristics, and disease progression in patients with dry age-related macular degeneration(AMD).
Two cohorts of dry AMD patients were enrolled in the COMPLement Inhibition with Eculizumab for the Treatment of Non-Exudative Age-Related Macular Degeneration (COMPLETE) Study. Cohort-1 was comprised of eyes with drusen in the absence of GA. Drusen volume was at least 0.03 mm3 within a 3 mm diameter circle centered on the fovea based on SDOCT. Drusen volume maps were obtained using SDOCT (Cirrus, Carl Zeiss Meditec), the 200x200 scan pattern, and a proprietary algorithm. Cohort-2 was comprised of eyes with GA measuring from 1.25 mm2 to 18 mm2 based on OCT fundus image. The choroid was visualized using enhanced depth imaging protocol with Spectralis (Heidelberg Engineering). Ophthalmologic exams, ETDRS visual acuity testing, and SDOCT studies were performed at baseline and follow-up months 3,6,9,and 12. The choroidal thickness and the area of GA were manually measured by two independent graders and a consensus image was used for quantitation. Axial length was obtained using the IOL master (Carl Zeiss Meditec Inc.). Statistical analyses were performed using two sample t-tests and Pearson correlations.
A total of 60 patients were enrolled in the study. Only one eye of each patient was included as a study eye. Fellow eyes meeting entry criteria were evaluated as secondary endpoint. In Cohort-1, a total of 43 eyes met entry criteria:30 study eyes and 13 fellow eyes. In Cohort-2, a total of 49 eyes met entry criteria:30 study eyes and 19 fellow eyes. Average choroidal thickness was 274.6 microns (SD=87.0) in Cohort-1 and 194.1 microns (SD=115.3) in Cohort-2 (p<0.001). Average area and volume of drusen at baseline in the central 3 mm were 2.1 mm2 (SD=1.0) and 0.17 mm3 (SD=0.19), respectively. Mean GA area at baseline was 6.5 mm2 (SD=4.2). Mean axial lengths were 23.4 mm (SD=1.2) in Cohort-1 and 23.3 mm (SD=1.0) in Cohort-2. There were no correlations between the choroidal thickness and the size of GA at baseline (p=0.16) or between the area/volume of drusen (p=0.81/0.49, r=0.04/0.12) at baseline. There was a correlation between axial length and choroidal thickness in both groups (p=0.002). The correlations between choroidal thickness and disease progression are currently being analyzed.
Eyes with GA demonstrate thinner choroids than eyes with drusen. This may reflect the fact that eyes with GA have more advanced disease or suggests that eyes with drusen represent a stage of disease that has active choroidal inflammation. The relationship between the choroid and disease progression will be presented.
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