A Brief Study about Choriocapillaris Vascular Density Changes: Healthy Vs. Advanced Exudative Age-related Macular Degeneration Previously Treated with Multiple Anti-VEGF Intravitreal Injections | Chapter 14 | New Horizons in Medicine and Medical Research Vol. 5

 The goal of this study was to use OCT-A to emphasise the differences in choriocapillaris VD in healthy ae-AMD eyes.

Introduction: Since the implementation of OCT-A in clinical practise, we have made significant progress in our understanding of age-related macular degeneration, particularly the exudative variety (AMD).

Method: In this observational, cross-sectional investigation, 21 healthy and 21 ae-AMD eyes were included, all of which had already been treated with anti-VEGF. All subjects had their Angio-View retina patterns focused on the fovea (6.4 mm) recorded using a Solix full-range OCT (Optovue Inc., Freemont, CA, USA). The primary goal of the study was to examine choriocapillaris VD in healthy and ae-AMD eyes. For the analysis, automated measurements of whole image choriocapillaris VD (percent) and fovea grid-based (percent) were taken. The contour flow measure algorithm was utilised to assess the flow area (mm2) of macular neovascularization (MNV) using Angio-View patterns. The statistical analysis included both groups' best-corrected visual acuity (BCVA).

The average age in healthy eyes was 60.9 (8.3), but in ae-AMD eyes it was 73.33 (15.05). The mean BCVA (ETDRS letters) in healthy eyes was 98.47 (1.50) and 7.04 (5.96) in ae-AMD eyes. The Mann–Whitney test revealed statistical significance when comparing choriocapillaries VD for entire and fovea healthy and ae-AMD eyes (p 0.0001 (t = 4.91; df = 40) and p 0.0001 (t = 6.84; df = 40), respectively). The link between MNV and VD of choriocapillaries was not statistically significant in either the entire or fovea areas (F = 0.38 (R2 = 0.01) and 1.68 (R2 = 0.08), respectively). Furthermore, type 3 MNV was found to have higher choriocapillaris non-perfusion in this investigation. The choriocapillaris is particularly fascinating to research when it comes to the pathogenesis of type 3 MNV.

Conclusions: In ae-AMD eyes, choriocapillaris VD was statistically significantly lower than in healthy eyes. In the early stages of MNV pathogenesis, choriocapillaris dysfunction might be noticed. Future applications could be used to assess choriocapillaris VD in a variety of MNVs, including Type 1, Type 2, Combined Type 1–Type 2, RAP, and polypoidal choroidal vasculopathy (PCV).

Author(S) Details

Maria Cristina Savastano
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Clara Rizzo
Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy.

Gloria Gambini
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Alfonso Savastano
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Benedetto Falsini
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Daniela Bacherini
Department of Surgery and Translational Medicine, AOU Careggi, University of Florence, 50139 Florence, Italy.

Carmela Grazia Caputo
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Raphael Kilian
Ophthalmology Unit, University of Verona, 37134 Verona, Italy.

Francesco Faraldi
Torino, Eye Clinic, ASL Torino 5, 10024 Turin, Italy.

Umberto De Vico
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy

Stanislao Rizzo
Unit of Ophthalmology, Fondazione Policlinico A. Gemelli, IRCCS, 00191 Rome, Italy and Unit of Ophthalmology, Università Cattolica Sacro Cuore, 00168 Rome, Italy and Consiglio Nazionale della Ricerca (CNR), Istituto di Neuroscienze, 56124 Pisa, Italy.


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