Abstract
Purpose :
In eyes with age-related macular degeneration (AMD), the presence of a cilioretinal artery (CRA) and higher retinal vessel density (VD) are associated with lower risk of choroidal neovascularization (CNV). Here, we determine whether VD as measured on OCT angiography (OCT-A) may account for the protective effect of the CRA against exudative AMD.
Methods :
We performed a retrospective, cross-sectional analysis of 435 eyes of 247 patients diagnosed with AMD at the University of California, Davis between January 27, 2017 and February 28, 2019 to determine CRA presence from fluorescein angiography (FA), color fundus photography (CFP), or infrared reflectance (IR), and measured retinal vascular perfusion including VD within the foveal 1mm subfield, parafoveal 1-3mm ring, and full 3mm macular field, as well as foveal avascular zone (FAZ) area, perimeter, and circularity. We determined associations between age, CRA presence, or AMD subtype with VD or FAZ parameters using logistic regressions with generalized estimating equations.
Results :
We found 48 of 435 (11.0%) eyes had a CRA. VD decreased with age in the foveal (B = -.224, P < 0.001), parafoveal (B = -.244, P < 0.001), and macular (B = -.229, P < 0.001) regions, but were not associated with the presence of a CRA (P = 0.526 - 0.911). FAZ area (P = 0.014), perimeter (P = 0.010), and circularity (P = 0.046) also worsened with older age, but was not affected by CRA presence (P = 0.112 - 0.736). Eyes with exudative AMD exhibited lower parafoveal (29.8% ± 6.3% vs. 33.0% ± 5.7%, P < 0.001) and macular VD (27.9% ± 6.2% vs. 31.2% ± 5.5%, P < 0.001), regardless of CRA status.
Conclusions :
Although CRA presence and higher VD are both associated with a lower prevalence of CNV, eyes with CRA do not exhibit higher VD, suggesting that the protective effect of a CRA is not mediated by greater retinal perfusion in the macula.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.