June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Choriocapillaris changes in myopic macular degeneration
Author Affiliations & Notes
  • Jonathan Li
    University of California San Francisco, San Francisco, California, United States
  • Hao Zhou
    Department of Bioengineering, University of Washington, Washington, United States
  • Jessica Wong
    University of California San Francisco, San Francisco, California, United States
  • Ruikang K Wang
    Department of Bioengineering, University of Washington, Washington, United States
  • Lawrence Chan
    University of California San Francisco, San Francisco, California, United States
  • Yining Dai
    Department of Bioengineering, University of Washington, Washington, United States
  • Travis C Porco
    University of California San Francisco, San Francisco, California, United States
  • Jacque L Duncan
    University of California San Francisco, San Francisco, California, United States
  • Daniel Schwartz
    University of California San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Jonathan Li, None; Hao Zhou, None; Jessica Wong, None; Ruikang Wang, None; Lawrence Chan, None; Yining Dai, None; Travis Porco, None; Jacque Duncan, 4D Therapeutics (C), Acucela (F), AGTC (C), Allergan/Abbvie (F), Astellas (C), Biogen/Nightstarx Therapeutics (F), DTx Therapeutics (C), Editas (C), Eloxx (C), Eyevensys (C), Gyroscope (C), Horoma (C), Neurotech USA (F), ProQR Therapeutics (C), RxSight, Inc (I), Second Sight Medical Products (F), SparingVision (C), Spark Therapeutics (C), Verdere Bio (C); Daniel Schwartz, None
  • Footnotes
    Support  L.L. Hillblom Foundation, the Hedco Foundation, the UCSF Vision Core shared resource of the NIH/NEI P30 EY002162 and an unrestricted grant from Research to Prevent Blindness, Foundation Fighting Blindness and the Claire Giannini Fund.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2268. doi:
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    • Get Citation

      Jonathan Li, Hao Zhou, Jessica Wong, Ruikang K Wang, Lawrence Chan, Yining Dai, Travis C Porco, Jacque L Duncan, Daniel Schwartz; Choriocapillaris changes in myopic macular degeneration. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2268.

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

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Abstract

Purpose : Myopic macular degeneration (MMD) is rapidly increasing in prevalence worldwide, and severe forms can cause irreversible loss of vision. Recent studies have shown an association between decreased choroidal thickness and increased grade of MMD. Our cross-sectional study aimed to further characterize this choroidal thinning by analyzing choriocapillaris alterations in MMD.

Methods : We recruited controls (n=51 eyes) and high myopes (spherical equivalent ≤ -6 diopters; n=16 eyes) from clinic at the University of California San Francisco. Axial length (AL) from A-scan, best corrected visual acuity (BCVA), fundus photos, and swept-source optical coherence tomography angiography (SS-OCTA) were measured. Fundus photos were graded for stage of MMD by 2 independent ophthalmologists. Inclusion criteria for subjects were those with Grade 2 MMD (diffuse chorioretinal atrophy) and high axial myopia (AL ≥ 26.5 millimeters [mm]). Subjects without MMD, with ages from 19-88 years old (mean=56) and AL from 21.65 to 25.84mm (mean=23.87), were used as controls. Exclusion criterion was BCVA worse than 20/40. 3x3mm SS-OCTA scans were acquired and choriocapillaris (CC) mean thickness was measured by identifying CC peaks in OCTA A-scan intensity profiles. CC flow void percent (CC FV%) was quantified using a fuzzy C-mean thresholding method on enface OCT-A images of an 8-um CC slab below Bruch's membrane. Multivariate regression models were analyzed comparing CC thickness and CC FV% between subjects and controls, with a linear correction for age.

Results : Subjects with diffuse chorioretinal atrophy had both a significantly decreased CC thickness and increased CC FV% compared to controls. CC thickness in subjects with diffuse chorioretinal atrophy measured 5.23 ± 0.68 um (mean ± standard deviation) versus 15.45 ± 1.82 um in controls (p<0.001). CC FV% in subjects with diffuse MMD measured 26.5 ± 0.04 versus 11.6 ± 0.04 in controls (p<0.001).

Conclusions : Patients with diffuse chorioretinal atrophy and good visual acuity had a 66% reduction in CC thickness and a 230% increase in CC FV% compared to controls. Although these patients have essentially normal BCVA and outer retinal landmarks on optical coherence tomography, they demonstrate significant choriocapillaris alterations that are consistent with reduced perfusion to the outer retina. These results point to a potential vascular etiology for MMD.

This is a 2021 ARVO Annual Meeting abstract.

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