Choroidal structural changes in different intermediate AMD patterns

Eur J Ophthalmol. 2022 Jan;32(1):460-467. doi: 10.1177/1120672121992009. Epub 2021 Jan 28.

Abstract

Purpose: To report variation of choroidal thickness (CT) and choroidal vascularity index (CVI) in subjects with drusen and subjects with reticular pseudodrusen (RPD) compared with healthy individuals using the Spectral-domain (SD)-Optical Coherence Tomography with enhanced depth imaging (EDI) system.

Design: A prospective, observational, cross-sectional study.

Subjects: Eighty-four participants.

Methods: The patients were imaged using the Heidelberg Spectralis device (Heidelberg Engineering, Heidelberg, Germany) with EDI mode. EDI-OCT images were exported and then imported into image analysis ImageJ software (National Institutes of Health, Bethesda) and a semiautomated algorithm was used for subsequent quantitative analysis.

Main outcome measures: This study evaluated two choroidal parameters: (i) choroidal thickness (CT); (ii) choroidal vascularity index (CVI).

Results: CT analysis was performed in three different regions: (i) foveal region, (ii) parafoveal region; (iii) perifoveal region. All the analyzed regions were significantly decreased in RPD pattern, as compared with both the drusen group (p < .005) and healthy eyes (p < .005). CVI was significantly decreased in the RPD pattern, as compared with healthy eyes (p < 0.001). However, the drusenoid pattern did not have statistical significance in comparison with the control group suggesting the lower incidence of this pattern on choroidal vasculopathy.

Conclusions: We report CT and CVI difference in RPD and drusen eyes. The RPD pattern seems to be a consequence of an alteration in the choroidal vascularity resulting in severe ischemia and excessive hypoxia inducing an increased risk of late AMD compared to the drusenoid pattern.

Keywords: Retinal degenerations associated with systemic disease; macular and RPE dystrophies; retina - medical therapies; retinal cell biology; retinal pathology/research.

Publication types

  • Observational Study

MeSH terms

  • Choroid* / diagnostic imaging
  • Cross-Sectional Studies
  • Fluorescein Angiography
  • Humans
  • Prospective Studies
  • Retinal Drusen* / diagnostic imaging
  • Tomography, Optical Coherence