Plexus-specific detection of retinal capillary nonperfusion in neovascular age-related macular degeneration with projection-resolved OCT angiography.

Abstract

Purpose : Histopathological studies have demonstrated nonfunctional retinal capillaries in eyes with nAMD. The purpose of the study is to compare the plexus-specific retinal capillary nonperfusion with projection-resolved OCT angiography (PR-OCTA) in eyes with nAMD compared to healthy control eyes.

Methods : In this cross-sectional study, eyes with treatment-naÏve nAMD underwent macular 3x3-mm OCTA with AngioVue system. OCTA scans were analyzed and processed including 3-dimensional projection artifact removal, retinal layer semi-automated segmentation, and en face angiogram generation. Automated quantification of retinal total avascular area (TAA) and extrafoveal (excluding the central 1-mm circle) avascular area (EAA) were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) respectively. The TAA and EAA on each of the three plexuses was compared between eyes with nAMD and healthy age-matched controls using Mann-Whitney U test.

Results : The clinical characteristics of 24 eyes with nAMD and 16 controls eyes are summarized in table 1. Compared to control eyes, nAMD eyes had significantly larger total avascular area (TAA) in SVC (median 0.442 vs. 0.273 mm², P=0.01) and DCP (0.363 vs. 0.207 mm², P=0.003), and only mildly larger TAA in ICP (0.260 vs.0.206 mm², P=0.092) [Fig.1]. EAAs in nAMD eyes were significantly larger in SVC (median 0.149 vs. 0.042 mm2, P＜0.001), ICP (0.018 vs. 0.000 mm², P=0.002), and DCP (0.039 vs. 0.000 mm², P＜0.001) compared with the control eyes.

Conclusions : PR-OCTA showed that nAMD is associated with focal nonperfusion in all retinal vascular plexuses.

This is a 2020 ARVO Annual Meeting abstract.

 

Table1. Clinical Characteristics of Study Participants with Neovascular Age-Related Macular Degeneration and Age-Matched Controls.

 

Fig.1 Eyes with neovascular age-related macular degeneration have greater areas of nonperfusion (labeled as blue areas) compared to age-matched healthy controls.