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Joana Providencia Costa, Inês Laíns, Jay Wang, Pedro Gil, Grayson W. Armstrong, Joao Gil, Steven Mach, Demetrios G. Vavvas, Ivana K Kim, Joan W Miller, Deeba Husain, John B Miller, Rufino Silva; Choroidal Thickness in Age-related Macular Degeneration: the Role of Subretinal Drusenoid Deposits. Invest. Ophthalmol. Vis. Sci. 2017;58(8):393.
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The relationship of subretinal drusenoid deposits (SDD) and choroidal thickness in Age-related Macular Degeneration (AMD) remains unclear. This study aimed to evaluate choroidal thickness in eyes with intermediate AMD with and without SDD, exploring the advantages of swept-source Optical Coherence Tomography (OCT).
Multicenter, prospective, cross-sectional study, including patients diagnosed with intermediate AMD, without any other vitreoretinal pathology. All subjects underwent complete ophthalmological exam and color fundus photography (Topcon® TRC 50DX), used for AMD diagnosis and grading, according to the Age-Related Eye Disease Study (AREDS) grading scheme. Additionally, participants were imaged with spectral domain OCT (SD-OCT) (Spectralis®, Heidelberg) and swept-source OCT (SS-OCT, 3D horizontal volume) (Atlantis, Topcon®). Two independent graders evaluated SD-OCT images for the presence of SDD and classic drusen. SS-OCT was used to obtain automatic macular choroidal thickness maps, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. For data analysis, we considered mean choroidal thickness as the arithmetic mean value of the 9 sectors of the ETDRS grid. Multilevel mixed linear models (to account for the inclusion of two eyes of same subject) were performed for analysis.
We included 186 eyes of 118 subjects, aged 74.4 ± 9.0 years, mostly females (n=113, 60.7%). One hundred and seventy-two (92.5%) presented classic drusen, 94 (50.5%) SDD, and 84 (48.8%) both. Multivariate analysis revealed that, controlling for age, eyes with SDD presented a statistically significantly decreased mean choroidal thickness (ß=-21.9, p=0.006). Similarly, the presence of SDD was significantly associated with decreased choroidal thickness in the central fovea (ß=-25.6, p=0.006) and in all the remaining ETDRS fields (p≤0.026), even after accounting for age.
Our data reveals that, in subjects with intermediate AMD, choroidal thickness is reduced in the presence of SDD. However, the relevance of this association for the pathophysiology of the disease is still not fully understood.
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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