Reduced Choriocapillaris Flow Accompanies Subretinal Drusenoid Deposits in AMD

A reduced choriocapillaris flow area in the central macula can be observed upon optical coherence tomography-angiography (OCT-A) evaluation in individuals with early age-related macular degeneration (AMD) who have subretinal drusenoid deposits, according to a study published in Eye.

Researchers enrolled 99 participants, including individuals with subretinal drusenoid deposits (n=33; mean age, 80.09 years), patients with conventional drusen (n=33; mean age, 77.42 years), and age-matched control group participants (n=33; mean age, 76.82 years), in the multicenter, observational, cross-sectional study. The team evaluated central macular choriocapillaris flow area in participants with subretinal drusenoid deposits and vessel density of the superficial and deep capillary plexus (SCP and DCP, respectively) in participants with conventional drusen and subretinal drusenoid deposits.

Two researchers performed comprehensive ophthalmologic examinations and OCT-A assessment on all study participants, which was reviewed by another 2 investigators.

The mean central macular choriocapillaris flow area among individuals with subretinal drusenoid deposits was significantly reduced compared with control group participants (1.71 vs 2.00 mm²; P ≤.001). There was also a non significant trend of vessel density reduction in the retinal SCP and DCP in both individuals with subretinal drusenoid deposits and conventional drusen compared with those of the control group, according to the report.

“[Choroicapillaris] flow area reduction of the central macular area in eyes with [subretinal drusenoid deposits] alone, where deposits are rarely found, and the trend of reduced [vessel density] of the retinal SCP and DCP in [subretinal drusenoid deposits] and [conventional drusen] phenotypes suggests generalized microvascular alterations in early AMD,” according to the study authors. “This suggests a novel treatment for AMD might be revascularization of the [choriocapillaris]. The qualitative and quantitative information provided by OCTA can contribute to improved classification and prognostic information
on AMD phenotypes.”

Study limitations include potential artifacts and segmentation errors associated with OCT-A technology.