June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Choriocapillaris Impairment Prior to Nascent Geographic Atrophy Development
Author Affiliations & Notes
  • Eugenia Custo Greig
    Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Eric Moult
    Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
  • Ivana N Despotovic
    New England Eye Center, Boston, Massachusetts, United States
  • Lauren AB Hodgson
    Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
  • James G Fujimoto
    Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
  • Nadia K Waheed
    New England Eye Center, Boston, Massachusetts, United States
  • Robyn H Guymer
    Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
  • Zhichao Wu
    Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Eugenia Custo Greig None; Eric Moult None; Ivana Despotovic None; Lauren Hodgson None; James Fujimoto Topcon, Code F (Financial Support), Optovue, Code I (Personal Financial Interest), Optovue, Code P (Patent), VISTA-OCTA, Code P (Patent); Nadia Waheed Novartis, Code C (Consultant/Contractor), Topcon, Code C (Consultant/Contractor), Roche, Code C (Consultant/Contractor), Boehringer Ingelheim, Code C (Consultant/Contractor), Regeneron, Code C (Consultant/Contractor), Apellis, Code C (Consultant/Contractor), Astellas, Code C (Consultant/Contractor), Nidek, Code S (non-remunerative); Robyn Guymer Roche, Code C (Consultant/Contractor), Genentech, Code C (Consultant/Contractor), Apellis, Code C (Consultant/Contractor), Novartis, Code C (Consultant/Contractor), Bayer, Code C (Consultant/Contractor); Zhichao Wu None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1041 – F0288. doi:
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    • Get Citation

      Eugenia Custo Greig, Eric Moult, Ivana N Despotovic, Lauren AB Hodgson, James G Fujimoto, Nadia K Waheed, Robyn H Guymer, Zhichao Wu; Choriocapillaris Impairment Prior to Nascent Geographic Atrophy Development. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1041 – F0288.

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

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Abstract

Purpose : To assess whether choriocapillaris (CC) loss occurs prior to the development of nascent geographic atrophy (nGA) in intermediate age-related macular degeneration (iAMD) using optical coherence tomography angiography (OCTA) imaging.

Methods : Participants were enrolled as part of a prospective, longitudinal, observational study and underwent swept-source OCTA imaging (Zeiss PlexElite) at 6-month intervals. Only participants with reliable OCTA imaging in ≥2 visits and iAMD without nGA at baseline were included. CC flow deficit percentage (FD%; compensated for shadowing artifacts) and RPE volume/height measurements were determined for the visit prior to nGA development or final visit (n-1). Linear mixed models were utilized to examine the association between CC FD% and future nGA development at a global level and at a local level, defined by 120x120 µm superpixels (Figure 1).

Results : Of 105 eyes from 62 participants, 13 eyes from 10 participants developed nGA during the follow-up period. There was no significant difference in global CC FD% at the n-1 visit between eyes that developed nGA and those that did not (P = 0.399). In contrast, CC FD% was significantly higher in superpixels that developed nGA than those that did not (P < 0.001). However, the performance of CC FD% for predicting the development of nGA (area under the receiver operating curve [AUC] = 0.83) was not significantly different to the performance using RPE height alone (AUC = 0.83) or when using both CC FD% and RPE height (AUC = 0.84; P ≥ 0.48) at the superpixel level.

Conclusions : CC flow deficits were significantly greater within local regions (superpixels) that subsequently developed nGA compared to those that did not. This did not hold true at the global level. Although CC FD% did not aid in the prediction of nGA development, these findings provide further insights into the potential patho-etiology of atrophy development.

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

 

Figure 1: (A) En face OCTA choriocapillaris slab (5-25µm posterior BM) after shadowing compensation (n-1 visit). Red tracing represents area of future nGA development. (B) Central 5mm region-of-interest. (C) FD Binarization. (D) FD% heat map. (E) Super-pixel FD% heat map. Super-pixels measure 120µm x 120µm (or 20 x 20 A-scans) each.

Figure 1: (A) En face OCTA choriocapillaris slab (5-25µm posterior BM) after shadowing compensation (n-1 visit). Red tracing represents area of future nGA development. (B) Central 5mm region-of-interest. (C) FD Binarization. (D) FD% heat map. (E) Super-pixel FD% heat map. Super-pixels measure 120µm x 120µm (or 20 x 20 A-scans) each.

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