July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Choroidal vascular changes in early and advanced AMD: relationship with ARMS2 genotype
Author Affiliations & Notes
  • Robert F Mullins
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Elliott H Sohn
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Miles J Flamme-Wiese
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Meagan A Luse
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Austin J Reutzel
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Budd Tucker
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Edwin M Stone
    Institute for Vision Research, Iowa, United States
    Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • Footnotes
    Commercial Relationships   Robert Mullins, None; Elliott Sohn, None; Miles Flamme-Wiese, None; Meagan Luse, None; Austin Reutzel, None; Budd Tucker, None; Edwin Stone, None
  • Footnotes
    Support  NIH Grants EY026547, EY026087, the Elmer and Sylvia Sramek Charitable Foundation
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1342. doi:https://doi.org/
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      Robert F Mullins, Elliott H Sohn, Miles J Flamme-Wiese, Meagan A Luse, Austin J Reutzel, Budd Tucker, Edwin M Stone; Choroidal vascular changes in early and advanced AMD: relationship with ARMS2 genotype. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1342. doi: https://doi.org/.

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

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Abstract

Purpose : There is considerable evidence that early age-related macular degeneration (AMD) is characterized by degeneration of the choriocapillaris, the vascular supply for the RPE and photoreceptor cells. We sought to quantify the extent to which vascular loss is associated with disease progression to GA and the impact of ARMS2 A69S genotype on these features.

Methods : Human donor maculas from a previously unpublished cohort included 99 unaffected controls and 35 maculas with early AMD. In addition 7 maculas with clinically diagnosed geographic atrophy (collected from outside the zone of RPE degeneration) were studied. Morphometric analyses of choriocapillaris density, vascular lumen-to-stroma ratio in the outer choroid, and choroidal thickness were performed. Eyes were also genotyped for the A69S polymorphism in the ARMS2 gene.

Results : Choriocapillaris loss was observed in early AMD (Bonferroni corrected p=0.028) with greater loss in GA, observed outside of the areas of central RPE degeneration (pcorr <0.001). In contrast, choroidal thickness and lumen-to-stroma ratio in the outer choroid was not found to differ between controls and AMD eyes (p >0.05), suggesting that AMD-related changes in the choriocapillaris occur earlier and are more prevalent than those in the outer choroid. High-risk homozygous and heterozygous genotypes for ARMS2 A69S were associated with significantly thinner choroids (pcorr<0.01) but not with other vascular parameters.

Conclusions : These findings support the concept that choroidal vascular degeneration contributes to dry AMD and GA, with the most predominant damage in the choriocapillaris microvasculature. The AMD-associated risk variant in ARMS2 was associated with thin choroids but not with vascular degeneration. Addressing the capillary loss in AMD remains an important translational target.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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