Age-related assessment of choroidal angio-architecture over the macular region in healthy eyes using swept-source optical coherence tomography angiography.

Abstract

Purpose : The angioarchitecture of choroidal tissue exhibits an array of manifestations in healthy eyes. This study analyzed the age-related changes in the macular choroid in healthy eyes using swept-source optical coherence tomography angiography (SS-OCTA) in Indian subjects.

Methods : This was a cross-sectional, prospective, observational study enrolling 222 eyes of 116 healthy participants. SS-OCTA images were captured using the PLEX Elite 9000 (Carl Zeiss Meditec Inc., Dublin, CA, USA) with a 6x6mm pattern centered on the foveal center. Subfoveal choroidal thickness (CT) and choroidal volume (CV) were generated automatically through manufacturer tools available in the ARI hub network. Choroidal vascularity index (CVI) and choriocapillaris flow deficits (CCFD) were computed using ImageJ.

Results : CV was found to be significantly higher in females as compared to males (table). Overall, there was a significant positive correlation of CVI and CCFD, and a significant negative correlation of CT and CV with age. The relationship, however, was more complex, as decade-wise analysis showed that CT and CV increased until the 2^nd decade, followed by a decrease until the 6^th, and then an increase again in the 7^th and 8^th decades. CVI was highest in the 7^th decade. In contrast, CCFD increased consistently with age and in all the ETDRS rings (figure). CCFD was negatively correlated with CVI from the 3^rd to 6^th decades of life.

Conclusions : Choroidal parameters can show significant variations with age. While choriocapillaris shows a consistent worsening with age with increasing flow deficits, the relationship between age and the other choroidal parameters is more complex. These differences are not uniform or consistent with age, highlighting the importance of a normative reference database to assess the significance of choroidal alterations associated with disease.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Measurement values of choroidal parameters in the study cohort

 

Bar graph depicting the changes in the choroidal parameters in every decade of life.