• Choroidal Features May Predict GA Progression

    By Lynda Seminara
    Selected By: Richard K. Parrish II, MD

    Journal Highlights

    American Journal of Ophthalmology, May 2021

    Download PDF

    Shi et al. looked at eyes with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) to de­termine if changes in choriocapillaris perfusion and other choroidal param­eters could be used to predict disease progression. They found significant correlation between GA enlargement rates and choriocapillaris flow deficits from the entire scan region, including the area immediately adjacent to the GA.

    For this review of prospective ob­servational research involving swept-source OCT angiography (SS-OCTA), the researchers included 38 eyes of 27 patients with GA secondary to nonexudative AMD.

    The average age of the patients was 81 years, and 52% were women. Patients received follow-up for roughly 12 months (range, 10.4-13.2 months). SS-OCTA imaging was performed at baseline and the annual end point. Changes in mean choroidal thickness and choroidal vascularity index (CVI) were analyzed for potential correlation with the annual square root enlarge­ment rate of GA.

    The mean ± standard deviation (SD) area of GA was 4.98 ± 1.76 mm2 at baseline and 6.52 ± 2.16 mm2 approx­imately one year later. The mean ± SD square root enlargement rate of GA was 0.31 ± 0.15 mm/year. Neither foveal in­volvement nor reticular pseudodrusen contributed any significant difference to the GA enlargement rate. Moreover, there were no significant differences in findings for multifocal and unifocal GA lesions. Using the global threshold method, choriocapillaris flow deficit percentage values in each region were correlated strongly with the annual square root enlargement rates of GA. There were no meaningful differences in the rate of prediction between regions. The only choroidal parameter with a significant relationship to the annual square root enlargement rate of GA was CVI measurement inside the GA region (p = .03).

    The original article can be found here.