July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Spatial analysis of choriocapillaris flow deficits in staged dry AMD using swept-source OCTA
Author Affiliations & Notes
  • Phillip Braun
    Yale University, New Haven, Connecticut, United States
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Nihaal Mehta
    Brown University, Providence, Rhode Island, United States
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Isaac Gendelman
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • A. Yasin Alibhai
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Eric Moult
    Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
  • Akihiro Ishibazawa
    Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Osama Sorour
    Ophthalmology, Tanta University, Tanta, Egypt
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Caroline R Baumal
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Andre J. Witkin
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • James G Fujimoto
    Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
  • Jay S Duker
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Nadia K Waheed
    New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Phillip Braun, None; Nihaal Mehta, None; Isaac Gendelman, None; A. Yasin Alibhai, None; Eric Moult, None; Akihiro Ishibazawa, Nidek Medical Products, Inc. (F), Topcon Medical Systems, Inc. (F); Osama Sorour, None; Caroline Baumal, Carl Zeiss Meditec, Inc. (F), Genentech, Inc. (C); Andre Witkin, None; James Fujimoto, Carl Zeiss Meditech, Inc. - Licensed (P), Optovue, Inc. (I), Optovue, Inc. - Licensed (P); Jay Duker, Carl Zeiss Meditech, Inc. (F), Novartis Pharmaceuticals, Inc. (C), Optovue, Inc. (F), Roche AG (C), Topcon Medical Systems, Inc. (F); Nadia Waheed, Carl Zeiss Meditec, Inc. (F), Genentech (C), Macula Vision Research Foundation (F), Nidek Medical Products, Inc. (F), Optovue, Inc. (C), Regeneron (C), Topcon Medical Systems, Inc. (F)
  • Footnotes
    Support  Yale School of Medicine Medical Student Fellowship, Macula Vision Research Foundation
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3480. doi:https://doi.org/
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    • Get Citation

      Phillip Braun, Nihaal Mehta, Isaac Gendelman, A. Yasin Alibhai, Eric Moult, Akihiro Ishibazawa, Osama Sorour, Caroline R Baumal, Andre J. Witkin, James G Fujimoto, Jay S Duker, Nadia K Waheed; Spatial analysis of choriocapillaris flow deficits in staged dry AMD using swept-source OCTA. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3480. doi: https://doi.org/.

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

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Abstract

Purpose : Age-related macular degeneration (AMD) is a leading cause of vision impairment and loss worldwide. Initial studies have shown that the choriocapillaris in the foveal area appears to be preferentially affected by age. This study used OCTA to investigate variation in CC flow deficits in patients with various stages of AMD with distance from the fovea.

Methods : 3mm x 3mm swept-source (SS-) OCTA images from early dAMD patients (23 eyes) and intermediate dAMD patients (7 eyes) were analyzed using an algorithm to account for drusen shadowing followed by binarization and particle analysis to assess regional flow deficit percentage. Regions were defined by concentric circular areas centered on the fovea: a 1mm diameter circle, a 1.5mm diameter ring, a 2.5mm diameter ring, and a 2.5mm diameter circle. Parallel analysis was undertaken for 6mm x 6mm images (22 early, 8 intermediate dAMD eyes), with concentric circular areas defined by a 1mm diameter circle, a 3mm diameter ring, a 5mm diameter ring, and a 5mm diameter circle. Data were analyzed using simple univariate analysis, then a least-squares fit analysis of covariance to account for effect of age on the CC. A generalized estimating equation (GEE) was used additionally to account for use of fellow eyes in some patients.

Results : There was a significant difference (p < .05) between early and intermediate dAMD groups in none of the 3x3 but all of the 6x6 regions excepting the 5mm diameter ring on univariate analysis. On least-squares analysis of covariance, age but not dAMD stage was significant for all regions, a result that was duplicated using the GEE.

Conclusions : While univariate analysis suggests some significant difference in flow deficit percentage between early and intermediate dAMD groups in certain 6x6 regions, more powerful statistical models accounting for covariance and clustering suggest that any significant differences are more likely attributable to patient age than to the studied dAMD stages. This finding may suggest a strong and regionally-invariant similarity in macular CC density among individuals with early and intermediate dAMD.

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

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