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Jaya Badhwar Kumar, Justis Ehlers, Rishi P Singh, Aleksandra V Rachitskaya; Choroidal thickness as a prognostic factor in exudative age related macular degeneration.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):889.
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© ARVO (1962-2015); The Authors (2016-present)
The significance of choroidal thickness in age–related macular degeneration (AMD) is still unknown. It has been proposed that abnormalities in choroidal circulation contribute to pathogenesis of AMD. We investigated the relationship between choroidal thickness, visual acuity (VA), and response to anti-Vascular Endothelial Growth Factor (VEGF) therapy to determine whether choroidal thickness serves as a prognostic factor in AMD treatment burden.
Retrospective case series of 50 treatment naive exudative AMD patients who were followed for 1 year and treated at providers’ discretion with anti-VEGF agents: bevacizumab, ranibizumab, or aflibercept. Choroidal thickness was measured at 3 locations utilizing enhanced depth imaging Cirrus spectral domain-OCT (Carl Zeiss Meditec, Dublin, CA): at the fovea and 500 um nasal and temporal to the fovea. Statistical analysis was performed using student t-test and Spearman’s rank correlation.
Mean choroidal thickness at baseline was 187 um (range: 75-345 um). The mean number of injections at 1 year was 7 (range: 3-12). Increased choroidal thickness at baseline showed statistically significant correlation with higher number of intravitreal injections at 1 year (p=0.0357, spearman’s rho 0.337). There was a trend of decreasing choroidal thickness at 6 months (mean 173 um (range: 48-352 um) compared to baseline (p=0.057). Thicker baseline choroidal thickness was not associated with better baseline VA (p=0.447) or change in VA at 12 months (p=0.0871). There was no statistical significant correlation between baseline choroidal thickness and presence of subretinal fluid (p=0.302) or intraretinal fluid at presentation (p=0.216).
Choroidal thickness in naïve wet AMD patients may be an important prognostic tool in determining treatment burden. Thicker subfoveal choroid may require increased intravitreal injections. There is a trend of decreasing choroidal thickness at 6 months compared to baseline.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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