A Brief Study about Choriocapillaris Vascular Density Changes: Healthy Vs. Advanced Exudative Age-related Macular Degeneration Previously Treated with Multiple Anti-VEGF Intravitreal Injections

Authors

  • 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.

DOI:

https://doi.org/10.9734/bpi/nhmmr/v5/2016B

Keywords:

Advanced exudative AMD, age-related macular degeneration, innovative biotechnologies, macular neovascularization, OCT angiography, personalized medicine, biomarkers

Abstract

Purpose: The aim of our study was to highlight the differences between choriocapillaris VD in healthy ae-AMD eyes by OCT-A.

Introduction: The introduction of OCT-A in clinical practice, we have continued to gain considerable advancements in our knowledge regarding age-related macular degeneration, mostly for the exudative type (AMD).

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). Furthermore, this study noted greater choriocapillaris non-perfusion in type 3 MNV. Considering the pathogenesis of type 3 MNV, it is particularly interesting to study the choriocapillaris.

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. Future applications would be useful to assess choriocapillaris VD in different MNV such as Type 1, Type 2, Combined Type1-Type 2, retinal angiomatous proliferation (RAP), and polypoidal choroidal vasculopathy (PCV).

Published

2022-04-11

How to Cite

Maria Cristina Savastano, Clara Rizzo, Gloria Gambini, Alfonso Savastano, Benedetto Falsini, Daniela Bacherini, … Stanislao Rizzo. (2022). A Brief Study about Choriocapillaris Vascular Density Changes: Healthy Vs. Advanced Exudative Age-related Macular Degeneration Previously Treated with Multiple Anti-VEGF Intravitreal Injections. New Horizons in Medicine and Medical Research Vol. 5, 156–174. https://doi.org/10.9734/bpi/nhmmr/v5/2016B

Issue

New Horizons in Medicine and Medical Research Vol. 5

Section

Chapters