Correlation Between Localized Choriocapillaris Perfusion and Macular Function in Eyes with Geographic Atrophy

PURPOSE: To test the hypothesis that choriocapillaris perfusion correlates with visual function in geographic atrophy (GA). DESIGN: Cross-sectional, single-center study METHODS: We imaged choriocapillaris flow using 6 x 6-mm swept-source optical coherence tomography angiography scans and measured retinal sensitivity using fundus-guided microperimetry in the central 20 degrees in 18 eyes of 12 patients with GA and 7 eyes of 4 healthy persons. Optical coherence tomography angiography scans were divided into a grid and microperimetry results were superimposed using retinal vascular landmarks. The main outcome measure correlated choriocapillaris flow deficit with retinal sensitivity at each localized region. Robust linear mixed effects regression compared flow deficit or sensitivity with distance from the fovea. The Pearson r correlation described the relationship between flow deficit or retinal sensitivity and distance from the GA border. RESULTS: Choriocapillaris flow deficit was significantly greater in patients with GA than in healthy persons (mean +/- SD: 24.2% +/- 7.9% vs 7.9% +/- 2.3%; P = .0015) and retinal sensitivity was significantly lower in patients with GA than in healthy persons (mean difference +/- SD:-17.0 +/- 1.2 dB; P < .001). In GA, choriocapillaris flow deficit decreased (r =-0.40; 95% CI:-0.54 to-0.27) and retinal sensitivity increased (r = + 0.63; 95% CI: 0.30 to 0.81) with distance from the GA margin. Choriocapillaris flow deficits inversely correlated with retinal sensitivity (r =-0.61; 95% CI:-0.75 to-0.42). CONCLUSIONS: Choriocapillaris flow and retinal sensitivity improved with distance from the GA margin. Choriocapillaris flow deficit was inversely correlated with sensitivity, supporting the hypothesis that choriocapillaris perfusion correlated with macular function. (C) 2021 The Author(s). Published by Elsevier Inc.

Automated summary

This study found that choriocapillaris flow deficit significantly increased in patients with geographic atrophy, while retinal sensitivity significantly decreased. An inverse correlation was observed between choriocapillaris flow deficit and sensitivity.