Progressive Choriocapillaris Changes on Optical Coherence Tomography Angiography Correlate With Stage Progression in AMD

• DOI: 10.1167/iovs.65.8.21
• Publication Date: 2024-07-11T13:31:11Z
• Authors: Francesco Romano; Xinyi Ding; Melissa Yuan; Filippos Vingopoulos; Itika Garg; Hanna Choi; Rodrigo Alvarez; Jack H. Tracy; Matthew Finn; Peyman Razavi; Isabella V. M. St...; Inês Laìns; Demetrios G. Vavvas; Deeba Husain; Joan W. Miller; John B. Miller
• Keywords: Male; Aged, 80 and over; Choroid; Fundus Oculi; Visual Acuity; Retinal Drusen; Middle Aged; Retina; Geographic Atrophy; Disease Progression; Wet Macular Degeneration; Humans; Female; Fluorescein Angiography; Tomography, Optical Coherence; Retrospective Studies; Aged; Follow-Up Studies

Purpose: We investigated the association between inner choroid flow deficit percentage (IC-FD%) using swept-source optical coherence tomography angiography (SS-OCTA) and progression of AMD. Methods: Retrospective, observational study including 64 eyes (42 participants) with early or intermediate AMD at baseline. Participants had two more consecutive covering a period least 18 months. Demographics, visual acuity, staging based on Beckman classification were reviewed. OCT was analyzed for hyperreflective foci, subretinal drusenoid deposits, hyporeflective drusen cores, subfoveal choroidal thickness. IC-FD% measured within central 3- 6-mm 16-µm slab, after compensation binarization (Phansalkar method). Mixed-effects Cox regression models assessed imaging biomarkers progression. Results: During follow-up (37 ± 9 months), 4 (31%) progressed to 30 (59%) developed late (19 geographic atrophy; 11 wet AMD). Baseline core associated atrophy development (P < 0.01), whereas greater (3-mm) = 0.03). Time-varying analysis showed that faster thickness reduction (6-mm) increase onset 0.05), Notably, increases in 3 mm (area under curve 0.72) 6 0.89) better predictive development, respectively. Conclusions: Our longitudinal assessment emphasizes role progressive choriocapillaris changes as biomarker findings support widespread alterations (6 mm) may precede atrophy, loss (3 provide an ischemic stimulus