Abstract
Purpose :
While the choroid is known to be involved in the pathogenesis of age-related macular degeneration (AMD), the role of the retinal vasculature is unknown. This retrospective cross-sectional study compared retinal vascular measurements between eyes with non-exudative and exudative AMD using optical coherence tomography angiography (OCT-A).
Methods :
We evaluated OCT-A images of 310 eyes (182 patients, mean age 78.8 ± 8.8 years) with non-exudative (54.2%) and exudative AMD (45.8%) to measure retinal vessel density (VD) in the foveal, parafoveal, and full 3mm macular region, and foveal avascular zone (FAZ) area, perimeter, and circularity in the superficial capillary plexus. Multivariate regression analyses were used to compare eyes with non-exudative and exudative AMD, adjusting for age and central subfield thickness (CST), as well as the impact of anti-vascular endothelial growth factor (anti-VEGF) treatments or geographic atrophy (GA).
Results :
In eyes with AMD, VD decreased with age in the foveal, parafoveal, and full macular regions (β = -0.211, P < 0.001; β = -0.305, P < 0.001; β = -0.295, P < 0.001). Eyes with exudative AMD showed significantly lower VD in foveal, parafoveal, and full regions as compared to eyes with non-exudative AMD (13.6 ± 7.2% vs. 16.7 ± 6.7%, P = 0.002; 29.8 ± 6.3% vs. 33.0 ± 5.7%, P < 0.001; 27.9 ± 6.2% vs. 31.2 ± 5.5%, P < 0.001). There was no difference in FAZ area, perimeter, or circularity between the two groups (P = 0.503 – 0.907). In eyes with exudative AMD, anti-VEGF treatments did not affect VD or FAZ measurements (P = 0.324 – 0.986). In eyes with non-exudative AMD, eyes with central GA also had lower VD in the parafoveal and full regions compared to eyes with no GA (28.7 ± 5.3% vs. 33.9 ± 5.2%, P = 0.007; 26.9 ± 4.9% vs. 32.0 ± 5.1%, P = 0.005).
Conclusions :
Retinal VD is decreased in eyes with exudative AMD compared to eyes with non-exudative AMD, suggesting a retinal vascular component in the pathogenesis of AMD.
This is a 2020 ARVO Annual Meeting abstract.