July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Choroidal Vessel Changes in Age-Related Macular Degeneration using Swept-Source Optical Coherence Tomography
Author Affiliations & Notes
  • John B Miller
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Ines Lains
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Jay Wang
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Joana Providencia Costa
    Coimbra University Hospital, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Rebecca F Silverman
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Demetrios Vavvas
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Ivana Kim
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Joan W Miller
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Deeba Husain
    Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Rufino Martins Silva
    Faculty of Medicine, University of Coimbra, Coimbra, Portugal
    Coimbra University Hospital, Coimbra, Portugal
  • Footnotes
    Commercial Relationships   John Miller, Allergan (C); Ines Lains, Allergan (R); Jay Wang, None; Joana Providencia Costa, None; Rebecca Silverman, None; Demetrios Vavvas, None; Ivana Kim, Alcon (C), Biophytis (C); Joan Miller, Alcon Research Institute (C), Alcon Research Institute (R), Genentech/Roche (C), Genentech/Roche (R), Kalvista Pharmaceuticals (C), Kalvista Pharmaceuticals (R), Lowy Medical Research Institute, Ltd. (F), ONL Therapeutics, LLC (C), ONL Therapeutics, LLC (P), ONL Therapeutics, LLC (R), Valeant Pharmaceuticals (P), Valeant Pharmaceuticals (R); Deeba Husain, None; Rufino Silva, Alcon (C), Alimera (C), Allergan (C), Bayer (C), Novartis (C), Thea (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2619. doi:
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      John B Miller, Ines Lains, Jay Wang, Joana Providencia Costa, Rebecca F Silverman, Demetrios Vavvas, Ivana Kim, Joan W Miller, Deeba Husain, Rufino Martins Silva; Choroidal Vessel Changes in Age-Related Macular Degeneration using Swept-Source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2619.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The role of the choroidal vasculature in the pathogenesis of Age-related Macular Degeneration (AMD) remains only partially understood. Recent studies have assessed choroidal thickness (CT) in this disease using spectral-domain optical coherence tomography (OCT). Swept-source OCT (SS-OCT) has important advantages for choroidal imaging, including enhanced penetration and resolution along with automated segmentation. Furthermore, the acquired en face images can provide additional assessments of choroidal vascularity. Herein, we compare choroidal vascular features of AMD eyes with a control group using SS-OCT.

Methods : Multicenter, cross-sectional study. We recruited subjects with AMD and controls without any vitreoretinal disease (> 50 years). All participants were imaged with color fundus photographs used for AMD staging according to the AREDS classification, and with SS-OCT (3D volume) on the same visit. En face images of the choroidal vasculature were obtained and converted to binary images on ImageJ. Choroidal vascular density (CVD) was then calculated as a percent area occupied by choroidal vessels in the central macular region (a 6-mm diameter circle centered on the fovea), and reported as average CVD (all image slices considered) and mid-point CVD (only image slices within 13 µm of mid-point). CT was obtained using SS-OCT automated software. The central macular choroidal vascular volume (CVV) was calculated by multiplying the CT by the average CVD within this area. Multilevel mixed linear models were performed for analyses.

Results : We included 611 eyes of 328 patients, 85% (n= 520) with AMD (105 early, 320 intermediate and 95 late), and 15% (n= 91) controls. Univariate analysis revealed that average CVD in the macular region was significantly lower in eyes with AMD than controls (b= -0.007, p= 0.002). After controlling for confounding factors, we observed that this was due to a reduced average CVD in eyes with late AMD (b= -0.028, p= 0.039). Similar results were obtained for mid-point CVD (b= -0.021, p= 0.006). Controlling for age, CT and CVV did not differ between eyes with AMD and controls.

Conclusions : Our results demonstrate that choroidal vascular density is significantly reduced in more advanced stages of AMD. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to AMD pathogenesis.

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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