J.ophthalmol.(Ukraine).2019;6:63-69.
http://doi.org/10.31288/oftalmolzh201966369
Received: 25 November 2019; Published on-line: 06 January 2020
SS-OCT-derived morphometric changes in the choroid in patients with age-related macular degeneration
D.O. Peretiahina, Post-graduate Student; N.A. Ulianova, Dr Sc (Med), Prof
Odesa National Medical University; Odesa (Ukraine)
E-mail: d.peretyagina@gmail.com
TO CITE THIS ARTICLE: Peretiahina DO, Ulianova NA. SS-OCT-derived morphometric changes in the choroid in patients with age-related macular degeneration. J.ophthalmol.(Ukraine).2019;6:63-69. http://doi.org/10.31288/oftalmolzh201966369
Background: Since the prevalence of late age-related macular degeneration (AMD) is increasing, investigating the role of the choroid in the pathogenesis of the disease is particularly important.
Purpose: To examine swept-source optical coherence tomography (SS-OCT)-derived subfoveal choroidal thickness (SFCT) in patients differing in phenotypic manifestations of AMD.
Material and Methods: Fifty-five AMD patients (67 eyes; age, 64 to 75 years) and 8 comparably matched-aged healthy controls (13 eyes) underwent SS-OCT measurement of SFCT. They were divided into 6 groups: healthy individuals without signs of AMD and patients with drusen; type 1 choroidal neovascularization (CNV); serous retinal pigment epithelium (RPE) detachment; type 1 CNV; and geographic atrophy (GA). Statistical analyses were conducted using Statistica software, version 13.5.0.17. Both parametric and non-parametric techniques were used.
Results: Mean SFCT in patients with GA was 47.8% lower than in controls, 45.7% lower than in patients with drusen, and 51.7% lower than in patients with type 1 CNV (p < 0.05). We found no significant difference in mean SFCT between patients with GA and those with RPE detachment, or between the former and those with type 2 CNV. Patients with AMD and age-matched healthy controls were divided into four clusters based on choroidal thickness (cluster I, 105 ± 4.8 ?m; cluster II, 188 ± 3.5 ?m; cluster III, 266 ± 4.6 ?m; and cluster IV, 408 ± 14.9 ?m). There was no difference in cluster distribution between eyes with type 1 CNV and normal age-matched eyes. Of the eyes with drusen, most (81.8%) were from cluster II. A statistically significant majority of eyes with serous RPE detachment, type 2 CNV, and dry AMD were assigned to clusters I and II (p < 0.05).
Conclusion: Patient groups differing in phenotypic manifestations of AMD were found to differ in the mean magnitude of SS-OCT-derived SFCT, and could be classified into 4 clusters on the basis of their value of SFCT.
Keywords: subfoveal choroidal thickness, age-related macular degeneration; optical coherence tomography
References
1.Li JQ, Welchowski T, Schmid M, Mauschitz MM, Holz FG, Finger RP. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol. 2019 Nov;11.
2.Garc?a-Layana A, Cabrera-L?pez F, Garc?a-Arum? J, Arias-Barquet L, Ruiz-Moreno JM. Early and intermediate age-related macular degeneration: update and clinical review. Clin Interv Aging. 2017 Oct 3;12:1579-1587. Doi: 10.2147/CIA.S142685. eCollection 2017.
3.Newman AM, Gallo NB, Hancox LS, Miller NJ, Radeke CM, Maloney MA, Cooper JB, Hageman GS, Anderson DH, Johnson LV, Radeke MJ. Systems levelanalysis of age-related macular degeneration reveals global biomarkers and phenotype-specific functional networks. Genome Med. 2012 Feb 24;4(2):16.
4.Lu L, Xu S, He F, Liu Y, Zhang Y, Wang J, Wang Z, Fan X. Assessment of Choroidal Microstructure and Subfoveal Thickness Change in Eyes With Different Stages of Age-Related Macular Degeneration. Medicine (Baltimore). 2016 Mar;95(10):e2967.
5.Saade C, Ganti B, Marmor M, Freund KB, Smith RT. Risk characteristics of the combined geographic atrophy and choroidal neovascularization phenotype in age-related macular degeneration. Br J Ophthalmol. 2014;98:1729-1732.
6.Invernizzi A, Benatti E, Cozzi M, Erba S, Vaishnavi S, Vupparaboina KK, Staurenghi G, Chhablani J, Gillies M, Viola F. Choroidal Structural Changes Correlate With Neovascular Activity in Neovascular Age Related Macular Degeneration. Invest Ophthalmol Vis Sci. 2018 Aug 1;59(10):3836-3841.
7.Kumar JB, Wai KM, Ehlers JP, Singh RP, Rachitskaya AV. Subfoveal choroidal thickness as a prognostic factor in exudative age-related macular degeneration. Br J Ophthalmol. 2019 Jul;103(7):918-921.
8.Ryoo NK, Ahn SJ, Park KH, Ahn J, Seo J, Han JW, Kim KW, Woo SJ. Thickness of retina and choroid in the elderly population and its association with Complement Factor H polymorphism: KLoSHA Eye study. PloS One. 2018 Dec 31;13(12):e0209276.
9.Marybeth K. Farazdaghi, Katayoon B. Ebrahimi. Role of the Choroid in Age-related Macular Degeneration: A Current Review. J Ophthalmic Vis Res. 2019 Jan-Mar; 14(1): 78-87.
10.Esmaeelpour M, Ansari-Shahrezaei S, Glittenberg C, Nemetz S, Kraus MF, Hornegger J, Fujimoto JG, Drexler W, Binder S. Choroid, Haller’s, and Sattler’s layer thickness in intermediate age-related macular degeneration with and without fellow neovascular eyes. Invest Ophthalmol Vis Sci. 2014 Jul 22;55(8):5074-5080.
11.Coscas F, Puche N, Coscas G, Srour M, Fran?ais C, Glacet-Bernard A, Querques G, Souied EH. Comparison of macular choroidal thickness in adult onset foveomacular vitelliform dystrophy and age-related macular degeneration. Invest Ophthalmol Vis Sci. 2014 Jan 3;55(1):64-69.
12.Korol AR, Khramenko NI, Zadorozhnyy OS, Kustrin TB. [Relationship of morphometric parameters of the vascular membrane and blood supply of the eye in patients with age-related macular degeneration]. Oftalmol Zh. 2013;3:23-26. Russian.
13.Jordana G. Fein, Lauren A. Branchini, Varsha Manjunath, Caio V. Regatieri, James G. Fujimoto, Jay S. Duker. Analysis of the Short Term Change in Subfoveal Choroidal Thickness in Eyes With Age Related Macular Degeneration Using Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina. 2014 Jan-Feb; 45(1): 32-37.
14.Age-related macular degeneration. NICE guideline [NG82]. Published date: January 2018. Available from: https://www.nice.org.uk/guidance/ng82
15.Vit VV. [The structure of the human visual system]. Odessa: Astroprint; 2018.
16.Arya M, Sabrosa AS, Duker JS, Waheed NK. Choriocapillaris changes in dry age-related macular degeneration and geographic atrophy: a review. Eye Vis (Lond). 2018;5:22.
17.Seddon JM, McLeod DS, Bhutto IA, Villalonga MB, Silver RE, Wenick AS, Edwards MM, Lutty GA. Histopathological Insights Into Choroidal Vascular Loss in Clinically Documented Cases of Age-Related Macular Degeneration. JAMA Ophthalmol. 2016 Nov 1;134(11):1272-1280.
18.Biesemeier A, Taubitz T, Julien S, Yoeruek E, Schraermeyer U. Choriocapillaris breakdown precedes retinal degeneration in age-related macular degeneration. Neurobiol Aging. 2014;35:2562-2573.
19.Lengyel I, Tufail A, Hosaini HA, Luthert P, Bird AC, Jeffery G. Association of drusen deposition with choroidal intercapillary pillars in the aging human eye. Invest Ophthalmol Vis Sci. 2004;45:2886-2892.
20.Korol AR, Zborovska O, Kustryn T, Dorokhova O, Pasyechnikova N. Intravitreal aflibercept for choroidal neovascularization associated with chorioretinitis: A pilot study. Clinical Ophthalmology. 2017;11:1315-1320.
21.Spraul CW, Lang GE, Grossniklaus HE. Morphometric analysis of the choroid, Bruch's membrane, and retinal pigment epithelium in eyes with age-related macular degeneration. Invest Ophthalmol Vis Sci. 1996 Dec;37(13):2724-35.
The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript