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Lauren A. Branchini, Caio V. Regatieri, Jonathan J. Liu, Ignacio Flores-Moreno, Namrata Nandakumar, Mehreen Adhi, James G. Fujimoto, Jay S. Duker; Choroidal Morphology in Neovascular Age Related Maculuar Degeneration as Compared with Healthy Controls Using Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2114.
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© ARVO (1962-2015); The Authors (2016-present)
Advancements in both hardware and software techniques have made reliable visualization of the choroid by Spectral Domain Optical Coherence Tomography (SDOCT) a reality. These advancements lead the way for sophisticated assessment of choroidal morphology. This investigation uses both manual measurement and automated software techniques to compare morphological characteristics of the choroid in eyes with neovascular age-related macular degeneration (wet AMD) with those of healthy controls using SDOCT.
Thirty three subjects (33 eyes) with wet AMD and 43 age-matched subjects (43 eyes) with no retinal or choroidal disease underwent high-definition raster scanning using SDOCT. Choroidal thickness (CT), defined as the distance from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction, was measured at the fovea. In the same location, the distance from the choroid/sclera junction to the closest large choroidal vessel was measured. All measurements were performed by 2 independent observers with a strong interobserver correlation.Custom software was used to calculate the ratio of choroidal stromal area to the choroidal vessel lumen area in the subfoveal region in eyes with wet AMD and healthy controls.
CT at the fovea was 196µm ± 80.8µm (mean ± SD) in eyes with wet AMD and 256.8µm ± 75.8 µm in healthy eyes (p=0.001). The thickness of the large vessel layer at the fovea was 104.1µm ± 43.5µm in eyes with wet AMD and 204.3µm ± 65.9µm in healthy eyes (p<0.001). The ratio of the large vessel layer to CT at the fovea was 0.53 ± 0.16 in eyes with wet AMD and 0.79± 0.067 in healthy eyes (p<0.001).The mean light/dark ratio, was 0.40 ± 0.089 in eyes with wet AMD and 0.26± 0.053 (SD) in healthy eyes (p<0.001).
In addition to confirming that the choroid is thinner in eyes with wet AMD as compared with their healthy counterparts, this investigation shows that compared with healthy controls, the large vessel layer of the choroid is thinner in subjects with wet AMD. The ratio of CT to the large vessel layer is significantly decreased in wet AMD implying that there is differential thinning of the choroid in wet AMD favoring the large vessel layer. The difference in light/dark ratio shows that there is proportionally less large vessel lumen area as compared to stromal area in the subfoveal region. Correlation of these anatomic observations with functional ones is necessary.
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