June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Analysis of choriocapillaris flow impairment in intermediate age-related macular degeneration as a predictor of progression to exudative choroidal neovascularization
Author Affiliations & Notes
  • Luísa Salles de Moura Mendonca
    New England Eye Center, Tufts University, Boston, Massachusetts, United States
    Ophthalmology, Federal University of Sao Paulo, Brazil
  • Jeffrey S Heier
    Ophthalmic Consultants of Boston, Boston, Massachusetts, United States
  • David S Boyer
    Retina-Vitreous Associates Medical Group, Los Angeles, California, United States
  • David M Brown
    Retina Consultants of Houston, Texas, United States
  • Sumit P Shah
    New Jersey Retina, New Jersey, United States
    Department of Ophthalmology, Robert Wood Johnson Medical School, New Jersey, United States
  • A. Yasin Alibhai
    New England Eye Center, Tufts University, Boston, Massachusetts, United States
  • Namrata Saroj
    All Eyes Consulting LLC, New York, United States
  • Sabin Dang
    The Retina Institute, Missouri, United States
  • Nadia K Waheed
    New England Eye Center, Tufts University, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Luísa Mendonca, None; Jeffrey Heier, 4DMT, Adverum, Aerie, Aerpio, Aldeyra, Allegro, Allergan, Annexon, Apellis, Array, Asclepix, Eloxx, Galimedix, Genentech, Generation Bio, Gyroscope, Interface, iRenix, Janssen R&D, jCyte, Kala, Kanghong, Kodiak, NGM Biopharmaceuticals, Notal Vision, Novartis, Ocugenix, Ocular Therapeutix, Regeneron, Regenxbio, Retrotope, Santen, Scifluor, Shire, Stealth Biotherapeutics, Takeda, Voyant (C), Adverum, Allegro, jCyte, Ocular Therapeutix (I), Aerie, Aerpio, Apellis, Clearside, Daiichi Sankyo, Genentech/Roche, Graybug, Gyroscope, Hemera, Janssen R&D, Kalvista, Kanghong, Novartis, Ophthotech, Optos, Regeneron, Regenxbio, Stealth Biotherapeutics (S); David Boyer, Alcon (C), Allegro (C), Allegro (I), Allergan (C), Bayer (C), Chengdu Kanghong Biotechnology (C), DigiSight (I), Ohr Pharmaceuticals, Inc, (I), Regeneron (C); David Brown, Novartis, Regeneron, Bayer, Genentech/Roche, Adverum, Kodiak, Senju,  ChengduKanghong Biotechnology, Boehringer Ingelheim, Allegro, Apellis, Geminni, Regenxbio, NEI, NGM, Ionis. Stealth, Outlook Therapeutics, Xbrane, Santen, Graybug, Heidelberg (F), Novartis, Regeneron, Bayer, Genentech/Roche, Optos, Adverum, Kodiak, Senju, ChengduKanghong Biotechnology,  Boehringer Ingelheim, Allegro, Apellis, Geminni, Regenxbio, Ocular Therapeutic, Stealth, Santen, iRenix Lineage Cell, Heidelberg, Navilas (C); Sumit Shah, Alimera Sciences, Inc, Paladin Study (F), Genentech, Inc, a Roche Group, (F), Glaxosmithkline (F), Jaeb Center for Health Research, DRCR Study (F), National Institutes of Health, SCORE 2 Study - PI (F), Ohr Pharmaceuticals, Inc, (F), Opthea, Ltd, (F), Regeneron Pharmaceuticals, Inc (F), University of Virginia (F); A. Yasin Alibhai, None; Namrata Saroj, Allegro (C), Allegro (I), Apellis (C), Regeneron (C); Sabin Dang, Regeneron (C); Nadia Waheed, Apellis (C), Apellis (S), Astellas (C), Astellas (S), Boehringer Ingelheim (C), Boehringer Ingelheim (S), Boston Image Reading Center (I), Carl Zeiss Meditec (S), Gyroscope (S), Nidek Medical Products (R), Novartis (C), Novartis (S), Ocudyne (I), Regeneron (C), Roche/Genentech (C), Roche Genentech (S), Topcon (C), Topcon (S)
  • Footnotes
    Support  Research to Prevent Blindness Challenge Grant / Massachusetts Lions Club Grant / Capes Foundation - Ministry of Education Brazil (Scholarship)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4092. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Luísa Salles de Moura Mendonca, Jeffrey S Heier, David S Boyer, David M Brown, Sumit P Shah, A. Yasin Alibhai, Namrata Saroj, Sabin Dang, Nadia K Waheed; Analysis of choriocapillaris flow impairment in intermediate age-related macular degeneration as a predictor of progression to exudative choroidal neovascularization. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4092.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Histology and imaging studies demonstrate choriocapillaris (CC) alterations at different stages of age-related macular degeneration (AMD). However, the relationship between CC changes and development of choroidal neovascularization (CNV) has not yet been elucidated. This study aims to evaluate whether the CC flow deficit percent (FD%) measured by spectral-domain OCT angiography (SD-OCTA) correlates with progression to exudative AMD.

Methods : Post-hoc analysis of the PRO-CON study, a prospective randomized clinical trial that studied the effect of prophylactic intravitreal aflibercept on the progression of eyes with intermediate AMD to exudative AMD was performed. Subjects that completed 24-months of follow-up and had good quality SD-OCTA images at baseline were included. CC projections were generated using a 20-μm thick slab starting at Bruch's membrane on 6mm × 6mm images. FD% was calculated after binarization using a locally applied Phansalkar threshold. Areas under drusen and retinal projection artifacts were excluded from the final calculation of FD% (Figure 1). Association between FDs% and progression was assessed using logistic regression.

Results : 99 eyes from 99 subjects were included for this analysis. The mean age of the subjects was 78.49 ± 7.65; 52.53% were males and 49.49% were in the treatment group. Twelve (12.12%) eyes progressed to exudative CNV. Mean FD% was 46.54 ± 3.72%. FD% showed a significant positive correlation with age (coefficient of 2.54 for 70-80 years; 3.28 for 80-90 years and 5.45 for > 90 years; p = 0.022; 0.005; 0.001; respectively). There was no significant association between FD% and progression (OR = 0.95; p = 0.56; 95% CI 0.79 1.13), after adjusting for age, gender and treatment.

Conclusions : There was no association between FD% and progression to exudative CNV in our small cohort of patients. Association between age and FD%, previously described in the literature, was confirmed by our analysis.

This is a 2020 ARVO Annual Meeting abstract.

 

A. En face OCTA CC slab and corresponding B-scan. B. RPE structural slab showing drusen and projection artifact. C. en face OCTA CC slab. D. RPE structural slab post binarization with Otsu Global Threshold. E. en face OCTA CC slab post binarization with Phansalkar auto local threshold. F. Resulting en face CC slab used for FD analysis, post drusen and projection artifact removal.

A. En face OCTA CC slab and corresponding B-scan. B. RPE structural slab showing drusen and projection artifact. C. en face OCTA CC slab. D. RPE structural slab post binarization with Otsu Global Threshold. E. en face OCTA CC slab post binarization with Phansalkar auto local threshold. F. Resulting en face CC slab used for FD analysis, post drusen and projection artifact removal.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×