Choriocapillaris Vascular Density Changes: Healthy vs. Advanced Exudative Age-Related Macular Degeneration Previously Treated with Multiple Anti-VEGF Intravitreal Injections

• Published in: Diagnostics (Basel) Vol. 11; no. 11; p. 1958
• Main Authors: Savastano, Maria Cristina, Rizzo, Clara, Gambini, Gloria, Savastano, Alfonso, Falsini, Benedetto, Bacherini, Daniela, Caputo, Carmela Grazia, Kilian, Raphael, Faraldi, Francesco, De Vico, Umberto, Rizzo, Stanislao
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 22.10.2021; MDPI
• Subjects: advanced exudative AMD; Age; age-related macular degeneration; Algorithms; Clinical medicine; Deep learning; Diabetes; Diabetic retinopathy; innovative biotechnologies; Macular degeneration; macular neovascularization; Medical imaging; OCT angiography; Oxidative stress; Pathogenesis; personalized medicine; Software; Variance analysis; Visualization; United States > US; Rome Italy; Italy
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics11111958

Purpose: To assess choriocapillaris vascular density (VD) in healthy and advanced exudative age-related macular degeneration (ae-AMD) patients by new full-range optical coherence tomography angiography (OCT-A). Method: In this observational, cross-sectional study, 21 healthy and 21 ae-AMD eyes, already treated with anti-VEGF, were enrolled. Angio-View retina patterns centered on fovea (6.4 × 6.4 mm) were acquired for all participants using Solix full-range OCT (Optovue Inc., Freemont, CA, USA). The main outcome was to compare choriocapillaris VD between healthy and ae-AMD eyes. Automated measurements of whole image choriocapillaris VD (%) and fovea grid-based (%) were collected for the analysis. Angio-View patterns were used to assess the flow area (mm2) of macular neovascularization (MNV) by contour flow measure algorithm. Best-corrected visual acuity (BCVA) of both groups was also used for the statistical analysis. Results: The mean age was 60.9 (±8.3) in healthy and 73.33 (±15.05) in ae-AMD eyes. The mean BCVA (ETDRS letters) was 98.47 (±1.50) in healthy and 7.04 (±5.96) in ae-AMD eyes. The Mann–Whitney test comparing choriocapillaries VD for whole and fovea healthy and ae-AMD eyes showed statistical significance (p < 0.0001 (t = 4.91; df = 40) and p < 0.0001 (t = 6.84; df = 40), respectively). Regarding, the correlation between MNV and VD of choriocapillaries, neither whole nor fovea areas were statistically significant (F = 0.38 (R2 = 0.01) and 1.68 (R2 = 0.08), respectively). Conclusions: Choriocapillaris VD showed a statistically significant reduction in comparison to healthy eyes in ae-AMD eyes. Choriocapillaris impairment can be seen in the early phase of MNV pathogenesis.