Author: Carlotta Senni (Italy)
Co-authors: Riccardo Sacconi, Marco Battista, Enrico Borrelli, Domenico Grosso, Francesco Bandello, Giuseppe Querques
To investigate the correlation between choroidal vascularity index (CVI) and the enlargement of geographic atrophy (GA) lesion secondary to age-related macular degeneration (AMD) during a 2-year follow-up.
This was a longitudinal observational study, including consecutive patients affected by GA secondary to dAMD presenting at the Medical Retina & Imaging Unit of the Department of Ophthalmology of University Vita-Salute San Raffaele in Milan, Italy. Patients presenting between January 2018 and October 2018 and followed for 2 years (until October 2020) were included. This study was conducted in agreement with the Declaration of Helsinki for research involving human subjects. All patients signed a written consent to participate in observational studies that was approved by the Local Ethics Committee
In this longitudinal observational study, 26 eyes of 26 patients (mean age 75.7±8.8 years) affected by GA secondary to AMD were included. All patients underwent structural optical coherence tomography (OCT) and fundus autofluorescence (FAF) at baseline and 2-year follow-up. CVI (the ratio between the luminal choroidal area and the total choroidal area) was calculated in the subfoveal 3000μm area. The main outcome measure included correlation analysis between baseline CVI and the rate of GA enlargement.
During the 2-year follow-up, visual acuity significantly decreased from 0.32±0.18 to 0.39±0.18 LogMAR(p<0.001), and mean GA area increased from 6.99±5.28 mm2 to 10.69±6.61 mm2(p<0.001), accounting for a growth rate of 0.33±0.17 mm/year after the square root transformation. Stromal choroidal area (SCA) significantly decreased during the 2-year follow-up(p<0.001). Interestingly, there was a significant correlation between the baseline CVI and the rate of GA enlargement (r=-0.432, p=0.027), and between SCA and the rate of GA enlargement (r=0.422, p=0.032). No other significant relationship was disclosed among choroidal parameters with the rate of GA enlargement.
CVI impairment is strictly related to the rate of enlargement during the 2-year follow-up in patients affected by GA. For this reason, CVI could be considered a predictor of GA progression in the clinical setting, and it could be considered as a new potential biomarker in the efficacy evaluation of new GA interventions.
Riccardo Sacconi is a consultant for: Novartis (Basel, Switzerland), and Zeiss (Dublin, USA). Enrico Borrelli is a consultant for: Novartis (Basel, Switzerland), and Zeiss (Dublin, USA). Francesco Bandello is a consultant for Alcon (Fort Worth,Texas,USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California,USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), NovagaliPharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee,Belgium), Zeiss (Dublin, USA). Giuseppe Querques is a consultant for Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California,USA), Amgen (Thousand Oaks, USA), Heidelberg (Germany), KBH (Chengdu, China), LEH Pharma (London, UK), Lumithera (Poulsbo, USA), Novartis (Basel, Switzerland), Bayer Shering-Pharma (Berlin, Germany), Sandoz (Berlin, Germany), Sifi (Catania, Italy), Soof-Fidia (Albano, Italy), Zeiss (Dublin, USA).