OCT-A in non-neovascular AMD

Abstract

Purpose : To analyse vascular pattern changes in non-neovascular Age-related Macular Degeneration (AMD), in patients featuring reticular pseudodrusen (RPD), drusen, or both RPD and drusen, by means of optical coherence tomography angiography (OCT-A).

Methods : Cross-sectional observational case series. Patients with non-neovascular AMD presenting at the Medical Retina Service of the Department of Ophthalmology, University Vita-Salute San Raffaele in Milan were involved. Tests performed: best-corrected visual acuity (BCVA), biomicroscopy, infrared reflectance, short-wavelength fundus autofluorescence (SW-FAF), and OCT-A (AngioPlex, CIRRUS HD-OCT 5000, Carl Zeiss Meditech, Inc., Dublin, USA). Main outcome: quantification of vessel density, stromal tissue, and vascular/stroma (V/S) ratio at the choriocapillaris (CC), the Sattler and Haller’s, and the whole choroid layers analysing the different kinds of non-neovascular AMD by means of binarized OCT-A scans.

Results : Forty-five eyes of 34 patients were enrolled (15 eyes of 11 patients with RPD as group 1; 15 eyes of 11 patients with drusen as group 2; 15 eyes of 12 patients with mixed phenotype as group 3). The CC, the Sattler and Haller’s, and the whole choroid vessels density were reduced in all groups of patients compared to healthy controls (p=0.023, p=0.007, and p=0.011 in group 1, group 2 and group 3 for the CC; p=0.021, p=0.037, and p=0.043 in group 1, group 2 and group 3 for the Sattler and Haller’s density; p=0.016, p=0.002, and p<0.001 in group 1, group 2 and group 3 for the choroidal density), with significantly lower V/S ratios.

Conclusions : Choroidal vascular depletion and fibrotic replacement are significant in patients with non-neovascular AMD. These findings show how vascular abnormalities may play a role in the pathogenesis and progression of the disease.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.