期刊
AMERICAN JOURNAL OF OPHTHALMOLOGY
卷 212, 期 -, 页码 7-16出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajo.2019.11.031
关键词
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资金
- National Eye Institute, United States [K08 EY026101, R21 EY031108]
- E. Matilda Ziegler Foundation for the Blind, United States
- Barr Foundation for Retinal Research, United States
- Macula Society, United States
PURPOSE: Although the choroid contributes to the pathogenesis of age-related macular degeneration (AMD), the role of retinal perfusion is unclear. We sought to compare retinal vascular measurements between eyes with nonexudative and exudative AMD using optical coherence tomography angiography (OCT-A). DESIGN: Retrospective, cross-sectional study. METHODS: OCT-A images were analyzed from 310 eyes of 182 patients (mean age +/- standard deviation [SD], 78.8 +/- 8.8 years) with nonexudative (54.2%) and exudative (45.8%) AMD to measure retinal vessel density (VD) from the superficial capillary plexus in the foveal, parafoveal, and full macular regions and foveal avascular zone (FAZ) area, perimeter, and circularity. Multivariate regressions were used to compare nonexudative and exudative AMD eyes and the impact of antivascular endothelial growth factor (anti-VEGF) treatments or geographic atrophy (GA). RESULTS: In eyes with AMD, VD decreases with age in the foveal (beta = - 0.211, P < .001), parafoveal (beta = - 0.305, P < .001), and full macular regions (beta = - 0.295, P < .001). Eyes with exudative AMD demonstrated lower VD, especially in the parafoveal (29.8% +/- 6.3% vs 33.0% +/- 5.7%, P < .001) and full regions (27.9% +/- 6.2% vs 31.2% +/- 5.5%, P < .001) compared with nonexudative AMD. There were no differences in FAZ area, perimeter, or circularity between the 2 groups (P = .503-.907). In eyes with exudative AMD, previous anti-VEGF treatments did not impact retinal vascular measurements (P = .324-.986). Nonexudative AMD severity and presence of central GA also impacted retinal VD and FAZ morphology. CONCLUSIONS: Retinal VD is decreased in eyes with exudative AMD compared with nonexudative AMD but is unaffected by anti-VEGF treatments, suggesting a retinal vascular contribution to the pathogenesis of AMD. (C) 2019 Elsevier Inc. All rights reserved.
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