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J.E. Grunwald, T.I. Metelitsina, R.M. Niknam, J.C. DuPont; Foveolar Choroidal Blood Flow in Patients with Age-related Macular Degeneration (AMD) That Have Choroidal Neovascularization (CNV) in the Fellow Eye . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4989.
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Purpose: We have previously reported that foveolar choroidal blood flow is decreased in patients with AMD and drusen. We have now investigated the choroidal circulation in AMD patients with CNV in the fellow eye. Methods: Nine AMD patients with drusen in one eye (study eye) and CNV in the fellow eye were included in this study. Mean age was 73 ± 6 years (± 1SD) and visual acuity was 20/40 or better in the study eye. Circulatory measurements obtained in these patients were compared with those of 10 normal controls with a mean age of 67 ± 9 years and a normal eye examination. Following pupillary dilatation, laser Doppler flowmetry (Oculix) was used to assess relative choroidal blood velocity (ChB Vel), volume (ChB Vol) and flow (ChB Flow) in the center of the fovea of the study eye of each subject. Mean arterial blood pressure (BPm), heart rate and intraocular pressure (IOP) were monitored following blood flow measurements. All circulatory measurements are shown in arbitrary units (AU). Results: Mean ChB Vel, ChB Vol, and ChB Flow were 0.40 ± 0.11AU, 0.22 ± 0.06AU, 7.3 ± 2.0AU in AMD patients and 0.47 ± 0.09AU, 0.25 ± 0.1AU and 10.5 ± 4.3AU in normal controls. In comparison to controls, a significant decrease of 30.5 % in ChB Flow (student's t-test, p=0.05) was seen in AMD eyes. The decreases in ChB Vel, and ChB Vol were not statistically significant (p=0.14, and p=0.36, respectively). BPm was significantly higher by 23.7% (p=0.03) in AMD subjects. A significant correlation was observed between BPm and ChB Flow in AMD patients (r= 0.859, p=0.003) and a nonsignificant correlation was detected in normal subjects (r=0.098, p=0.79) When all subjects were analyzed together, a significant inverse correlation between age and ChB Flow was also observed (r=-0.631, p=0.003). Conclusions: Choroidal blood flow is reduced in eyes of AMD patients that have CNV in the fellow eye. This raises the possibility that decreased foveolar choroidal blood flow in AMD eyes may have a role in the development of CNV in the same way as decreased flow is associated with neovascularization in other vascular tissues of the body.
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