Abstract
Purpose: :
To demonstrate the association of reticular macular disease (RMD), a sub-phenotype of age-related macular degeneration (AMD), with a specific choroidal vascular morphology on spectral domain optical coherence tomography (OCT).
Methods: :
57 eyes of 29 patients enrolled in the Columbia Macular Genetics Study were screened for RMD using color fundus, red free, and scanning laser ophthalmoscopy (autofluorescence and infrared) images. 16 of the patients had AMD with RMD, and 13 patients had AMD without RMD. We further evaluated all eyes using OCT and inverted OCT imaging. We analyzed a total of 1313 OCT images (815 from patients with RMD) and 934 inverted OCT images (485 from patients with RMD) for the presence of circular choroidal vascular sections (CCVS’s). CCVS’s were defined as vascular sections 50-150 µm in diameter with a circular morphology (long to short axis ratio < 1.2).
Results: :
51% (674/1313) of the OCT images were within reticular regions. 26% (172/674) of these images showed CCVS’s compared with 4% (54/1313) of images outside reticular regions. 45% (422/934) of the inverted OCT images were within reticular regions. 30% (128/422) of these images showed CCVS’s compared with 3% (31/934) of images outside reticular regions. 82% of all CCVS’s (483/591) appeared within a reticular region.
Conclusions: :
RMD is highly associated with a specific morphology of choroidal vessels as visualized on OCT. The size and shape of the vessels suggests dilation of pre-existing channels in response to choriocapillaris insufficiency.
Keywords: age-related macular degeneration • choroid • retina