June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Choroidal metrics as a predictor of progression from intermediate to late age-related macular degeneration
Author Affiliations & Notes
  • Muneeswar Gupta Nittala
    Doheny Eye Institute, Los Angeles, California, United States
  • Swetha Bindu Velaga
    Doheny Eye Institute, Los Angeles, California, United States
  • YU Wakatsuki
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Navid Manafi
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Alireza Mahmoudi
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Kiran Kumar Vupparaboina
    UPMC, Pittsburgh, Pennsylvania, United States
  • Jay Chhablani
    UPMC, Pittsburgh, Pennsylvania, United States
  • Charles Clifton Wykoff
    Retina Consultants of Texas, Houston, Texas, United States
  • SriniVas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Muneeswar Gupta Nittala None; Swetha Bindu Velaga None; YU Wakatsuki None; Navid Manafi None; Alireza Mahmoudi None; Kiran Vupparaboina None; Jay Chhablani None; Charles Wykoff Apellis, Genentech, IVERIC Bio, Janssen, Novartis, Regeneron , Code C (Consultant/Contractor), Apellis, Genentech, IVERIC Bio, Janssen, Novartis, Regeneron, Code R (Recipient); SriniVas Sadda 4DMT, Abbvie/Allergan, Amgen, Apellis, Astellas, Bayer, Biogen, Boerhinger Ingelheim, Centervue, Genentech/Roche, Heidelberg Engineering, Iveric, Nanoscope, Novartis, Optos, Oxurion, Regeneron, Code C (Consultant/Contractor), Carl Zeiss Meditec, Code F (Financial Support), Nidek, Code R (Recipient), Centervue, Heidelberg Engineering, Nidek, Optos, Topcon, Code S (non-remunerative)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2147. doi:
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      Muneeswar Gupta Nittala, Swetha Bindu Velaga, YU Wakatsuki, Navid Manafi, Alireza Mahmoudi, Kiran Kumar Vupparaboina, Jay Chhablani, Charles Clifton Wykoff, SriniVas R Sadda; Choroidal metrics as a predictor of progression from intermediate to late age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2147.

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

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Abstract

Purpose : To evaluate the choroidal thickness (CT) and choroidal vascularity index (CVI) as predictors of progression of intermediate age-related macular degeneration (iAMD) to geographic atrophy (GA/cRORA) vs exudative MNV (eMNV).

Methods : Sixty eyes from 60 subjects with iAMD who progressed to late AMD (30 progressing to cRORA and 30 progressing to eMNV) were included in this retrospective analysis. Eyes that developed both cRORA and eMNV during the follow-up period or which had poor visualization of the choroid were excluded. Spectral domain OCT (Heidelberg OCT; 49 B-Scans) were collected at baseline for all subjects. The inner and outer choroidal boundaries were manually segmented on the OCT B-scan passing through the foveal center, the space between the boundaries was binarized, and the luminal and stromal portions of the choroid were automatically segmented. Choroidal vascularity index (%) was calculated as the ratio of the luminal area to the total choroid area. The subfoveal choroidal thickness (SFCT) was measured using the instrument caliper tool. The presence of subretinal drusenoid deposits (SDD) was also noted. The CVI and SFCT between the iAMD which progressed to cRORA were compared to those which progressed to exudative MNV using an independent t-test (with a p< 0.05 considered statistically significant).

Results : The mean age of the patients who progressed to eMNV vs those that progressed to cRORA was not significantly different (73.43 ± 8.24 vs. 77.16 ± 8.51 years; p = 0.08). The mean duration of follow was 19.27 ± 15.52 months in the cRORA group and 15.86 ± 11.40 months in the eMNV group (p= 0.33). In the cRORA group, 19 were female compared to 17 in the eMNV group (p = 0.89). SDD were present at baseline in 21 iAMD eyes that developed cRORA and in 13 eyes with SDD in the eMNV group (p=0.37). The SFCT was significantly (p=0.03) thinner in the cRORA group (166 ± 77 µm) compared to the eMNV group (206 ± 98 µm). The CVI, however, was similar in both groups (64.9 ± 2.5 vs. 64.8 ± 3.5%; p=0.09).

Conclusions : Among eyes with iAMD, eyes that progressed to cRORA had a thinner subfoveal choroidal thickness compared to eyes that progressed to eMNV. Despite the difference in CT, there was no difference in CVI among these groups. This suggests that the reduction of both the stromal and luminal components of the choroid are relevant to AMD progression, but further studies are warranted.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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