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J. E. Grunwald, T. I. Metelitsina, J. C. DuPont, G. S. Ying, W. Xu, E. R. Martin, A. J. Brucker; Risk Factors for Choroidal Neovascularization in Age-Related Macular Degeneration (AMD) Are Associated With Decreased Foveolar Choroidal Circulation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):234.
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To investigate the relationship between known risk factors for AMD progression and foveolar choroidal circulation in eyes with dry AMD.
We investigated the association between choroidal blood flow parameters and age, history of hypertension, hyperopia and retinal pigment epithelium (RPE) hypertrophy, all known risk factors for AMD progression. Laser Doppler Flowmetry measurements (Oculix instrument) of relative choroidal blood velocity (ChBVel), volume (ChBVol) and flow (ChBFlow) were obtained in the center of the fovea of 261 study eyes of 190 AMD patients. Visual acuity of 20/40 or better, good fixation, and absence of other ocular pathology and choroidal neovascularization (CNV) were the inclusion criteria for the study eye. RPE hypertrophy was determined from color fundus photographs by trained masked graders at the Scheie Image Reading Center. Correlation and multivariate linear regression analysis were carried out with adjustments for significant covariates. The correlation between paired eyes from the same subject was adjusted by using the generalized estimating equations (GEE). Choroidal circulatory parameters are shown in arbitrary units (AU).
A significant inverse correlation was observed between age and ChBFlow (r=-0.35, p=0.0002), or ChBVol (r=-0.28, p=0.003) but not for blood velocity (r=-0.07, p=0.34). A significant inverse correlation was observed between spherical equivalent and ChBFlow (r=-0.22, p= 0.006), or ChBVol (r=-0.14, p=0.05) but not for blood velocity (r=-0.09, p=0.15).
All the described risk factors are associated with decreased choroidal circulatory parameters, suggesting that decreased choroidal blood flow may be involved in the development of CNV in AMD.
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