Author: Alessia Amato (Italy)
Co-authors: Alessandro Arrigo, Emanuela Aragona, Federico Borghesan, Andrea Saladino, Francesco Bandello, Maurizio Battaglia Parodi
Purpose
So far, little is known about the factors that influence the natural history of Age-Related Macular Degeneration (AMD). This study aims to assess the relationship between choroidal overall and sublayer thickness and AMD stage progression.
Setting/Venue
The study was designed as a prospective, observational case series. Patients affected by AMD at different stages were recruited at the Department of Ophthalmology of IRCCS San Raffaele Hospital, Milan, Italy. Written informed consent was obtained from all the study subjects. The study was approved by the ethical committee of IRCCS Scientific Institute San Raffaele Hospital, which verified its conduction in accordance with Helsinki declaration.
Methods
A prospective, observational case series was performed. 262 eyes of 262 patients with different stages of AMD were imaged by Optical Coherence Tomography (OCT). AMD stage, choroidal thickness (CT), Sattler layer-choriocapillaris complex thickness (SLCCT) and Haller layer thickness (HLT) were determined at the baseline visit, at a 1-year follow-up visit, at a 2-year follow up visit and at a final 3-year follow-up visit.
Results
Baseline AMD stages were distributed as follows: early AMD (30 eyes; 12%), intermediate AMD (97 eyes; 39%) and late AMD (126 eyes; 49%). At the final follow-up, AMD stages were so distributed: early AMD (15 eyes; 6%), intermediate AMD (83 eyes; 33%) and late AMD (156 eyes; 61%). Each group showed a statistically significant decrease in CT values over the entire follow-up (p ˂0.01) and SLCCT reduction was associated with AMD progression (p ˂0.01). Moreover, SLCCT quantitative cutoffs ˂20.50 µm and ˂10.5 µm were associated with a moderate and high probability of AMD progression, respectively, and SLCCT quantitative cutoffs ˂18.50 µm and ˂8.50 µm implied a moderate and high probability of MNV onset, respectively.
Conlusions
Progressive choroidal impairment contributes to AMD progression. Among choroidal layers, a reduced SLCCT is a promising biomarker of disease worsening and its quantitative evaluation could help to identify patients at higher risk of stage advancement.
Financial Disclosure
None.
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