Abstract
Purpose :
To evaluate the relationship between choriocapillaris (CC) flow deficits (FD) and structural optical coherence tomography (OCT) biomarkers, and the progression of intermediate age-related macular degeneration (iAMD) to complete retinal pigment epithelial and outer retinal atrophy (cRORA) or macular neovascularization (MNV).
Methods :
Multicenter retrospective analysis of consecutive patients with iAMD. Odds ratios for IHRF, hDC, SDDs, and high drusen volume, fellow eye with late AMD, duration of follow-up, peripheral and central CC FD estimated from logistic regression.
Results :
30 iAMD eyes from 30 patients were enrolled into each group. Among eyes which progressed to cRORA, there was a significantly higher proportion of eyes with IHRF, hDC and high drusen volume. The CC FD was greater in the peripheral sectors of the macula of eyes which progressed to cRORA compared to the other two groups (P < 0.0001). The central CC FD was also significantly impaired in eyes that progressed to cRORA or MNV compared to those that did not progress (P = 0.001 and P = 0.02, respectively). CC FD in the peripheral macula was significantly and independently associated with the development of cRORA, while CC FD in the center was significantly and independently associated with the development of MNV.
Conclusions :
While the CC is diffusely impaired throughout the macula in iAMD eyes that progress to cRORA, it is relatively spared in the more peripheral macula among eyes which progress to MNV. These differential findings may have implications for the pathophysiology of the different late stage manifestations of AMD.
This is a 2021 ARVO Annual Meeting abstract.