Author: Hilal Kilinc Hekimsoy (Turkey)
Co-authors: Mehmet Ali Sekeroglu, Halil İbrahim Atesoglu, Sibel Doguizi
Purpose
The pathogenesis responsible for age-related macular degeneration (AMD) involves environmental factors and varying susceptibilities to these external factors based upon different genetic backgrounds. There has been compelling documented evidence that heredity plays a role in AMD. The tendency for familial aggregation in AMD cases further points to a genetic background for the disease. Approximately 20% of AMD patients have a positive family history. The aim of this prospective cross-sectional study was to investigate the retinal microvasculature in adult offspring of patients with neovascular AMD (nAMD) who have no clinical evidence of retinopathy and to compare these with non- nAMD offspring.
Setting/Venue
Ulucanlar Eye Training and Research Hospital
Methods
Seventy-one adult offspring of patients with nAMD (41 males and 30 females, mean age 51.23 ± 7.39 years) and 81 age- and sex-matched healthy control subjects were included in the study. Data regarding age, gender and parenteral nAMD subtypes were recorded. Patients with smoking habits and systemic diseases including diabetes mellitus, systemic hypertension, pulmonary hypertension, heart failure and rheumatological disease were excluded. Exclusion criteria also encompassed the presence of retinal diseases, severe cataract, nystagmus, poor eye fixation, significant media opacity and refractive spherical and cylindrical error ≥2 D that could possibly confound the observation. After complete ophthalmological examination, all patients underwent optical coherence tomography angiography (OCTA) measurement (Optovue Inc., Fremont, California, USA) to assess the foveal avascular zone (FAZ) area; FAZ perimeter; acircularity index of FAZ; foveal density-300; superficial and deep capillary plexus vessel densities; and choriocapillaris flow area at 1mm radius. Three-dimensional OCTA scans were acquired over 6 mm × 6 mm regions. The data from the right eyes of all participants were used for statistical analysis.
Results
There was no significant difference between offspring of patients with nAMD and control groups in terms of age, gender distribution, spherical equivalent of refraction, and intraocular pressure (p = NS for all). The superficial capillary plexus vessel density of the whole image, fovea and perifovea were significantly lower than those in healthy control subjects (p= 0.025, p= 0.034, p= 0.046). The deep capillary plexus vessel density of the whole image, fovea and perifovea were significantly lower than those in healthy control subjects (p= 0.037, p= 0.044, p= 0.041). No significant difference was found in the FAZ area, FAZ perimeter, acircularity index of FAZ, foveal density-300 and choriocapillaris flow area measurements between the offspring and controls (p = NS for all).
Conlusions
Non-invasive quantitative analysis of retinal perfusion using OCTA in adult offspring of patients with nAMD demonstrated that macular vessel density was significantly lower in the study group compared to healthy controls. The results of our study supported the existence of hereditary factors in the pathogenesis of AMD and provided evidence which may explain the underlying mechanism of familial aggregation in AMD.
Financial Disclosure
The authors report no conflicts of interest The authors received no financial support for the research.
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