Association of subretinal drusenoid deposits on retinal vascular indices in patients with Intermediate Age-related macular degeneration

Abstract

Purpose : To investigate the association between the presence of subretinal drusenoid deposits (SDD) and retinal vascular indices in patients with intermediate age-related macular degeneration (iAMD).

Methods : Patients with intermediate AMD (based on clinical exam) and without other retinal or systemic diseases were invited to participate. Included participants underwent Swept Source-OCT Angiography (OCT-A) with Plex Elite 9000 (Zeiss), 12 mm x12 mm scan, centered on the macula; and spectral domain OCT (Heidelberg, Spectralis). The last was used to identify the presence of SDDs, which was defined as positive when at least one SDD was visible on SD-OCT imaging and confirmed on Infra-Red reflectance. The 12 mm x 12 mm OCT-A volume of the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) vessels were then exported, and projection artifacts were removed with the commercially available software. Vessel area density (VAD), vessel skeletonized density (VSD), Vessel Diameter Index (VDI), vessel perimeter index (VPI) and Vessel Complexity Index (VCI) were calculated using ImageJ software (Bethesda, MD). Vessel indices of the SCP and DCP were compared between patients with and without SDD. Multilevel mixed models were used to account for the inclusion of two eyes of some patients.

Results : We included 90 eyes of 58 patients (52% female); 41 (46%) with SDD. Our analyses revealed that eyes with SDD presented significantly lower VSD of the DCP (b=-0.428, p=0.043 ); VAD, VPD, VDI or VCI of the DCP did not differ significantly from eyes with classical drusen alone. No significant association were observed with SCP parameters when comparing eyes with SDD and those without these lesions.

Conclusions : Our study suggests that SDD are associated with retinal vasculature changes in the deep retinal vessels. This contributes to the current understand of the pathophysiology of these morphologic features, which have known important prognostic value.

This is a 2020 ARVO Annual Meeting abstract.