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Adel Ebraheem, Phuc Le, Sean Pitetta, Nizar Saleh Abdelfattah, Srinivas R. Sadda, Charles Clifton Wykoff; Effect of Cilioretinal Artery Hemodynamics on Macular Atrophy in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1454.
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Macular atrophy (MA) may be commonly observed in the setting of neovascular age-related macular degeneration (NVAMD), and MA has been shown to be less frequent in eyes with subretinal fluid (SRF). We recently demonstrated that the presence of a cilioretinal artery (CRA) can impact the presence and extent of SRF in NVAMD eyes. In this analysis, we evaluate the relationship between the CRA and MA.
As part of a prospective, randomized trial (TREX-AMD), 40 patients with treatment-naïve NVAMD were treated with 0.5 mg ranibizumab according to a treat-and-extend protocol; 8 patients were excluded for failure to complete the 18-month follow-up. Color fundus photos(CPF), fluorescein angiograms(FA), and spectral domain optical coherence tomography (SD-OCT) were obtained at regular intervals and analyzed by two masked graders. For this analysis, only the baseline and month 18 images were evaluated. CFPs and FAs of the study eye at baseline were reviewed to identify eyes with CRA and eyes without. SD-OCT images at baseline and Month 18 were evaluated for choroidal neovascularization subtype, cystoid macular edema, pigment epithelial detachment, subretinal hyperreflective material, foveal thickness, MA, and SRF. Independent sample t-test, univariate and multivariate analysis were performed to identify the relationship between MA (at baseline and Month 18) and other tested variables, including the CRA.
The mean MA area was significantly larger in eyes with CRA than eyes without CRA both at baseline (2.86 ± 6.4 mm2 vs. 0.09 ± 0.29 mm2; P = 0.024) and at month 18 (3.94 ± 6.06 mm2 vs. 1.11 ± 12.4 mm2; P = 0.032). Univariate analysis demonstrated that the presence of a CRA and SRF volume were the only variables significantly correlated with MA area at baseline (r = 0.44; P = 0.024) and (r = -0.41; P = 0.021) respectively. Multivariate analysis demonstrated that presence of CRA was the only variable that is correlated with MA (r = 0.35; P = 0.048); but MA area at month 18 was significantly correlated with the presence of CRA (r = 0.32; P =0.032), SRF volume (r = - 0.33; P =0.033), and atrophy at baseline (r = 0.8; P = 0.00). Multivariate analysis demonstrated that MA at the baseline was the only variable that is correlated with MA at month 18 (r = 0.8; P = 0.00)
Moderate yet significant positive correlations were identified between the presence of a CRA and MA.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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