Author: Cemile Atılgan (Turkey)
Co-authors: Gözde Hondur, Mehmet Çıtırık
Purpose
Age Related Choroidal Atrophy (ARCA) was first described by Richard F. Spaide in 2009 as an acquired disease that affects older individuals and may mimic the typical findings of age related macular degeneration (AMD). Spaide emphasized in this study that the patients with ARCA had higher risk for glaucoma. (Spaide RF. Age related choroidal atrophy. Am. J Ophthalmol. 2009:147;801-810) This cross-sectional study compared the peripapillary retinal nerve fiber layer (pRNFL) and macula segmented inner retinal layers in patients with age related choroidal atrophy (ARCA) and age-matched healthy controls.
Setting/Venue
Ulucanlar Eye Research and Training Hospital ANKARA
Methods
This cross-sectional and prospective study included 84 eyes of 84 patients: 40 eyes with ARCA (group 1) and 44 age and axial length matched healthy controls (group 2). Serial horizontal SD-OCT scans of the macula and optic disc were acquired from all participants. Peripapillary retina nerve fiber layer (pRNFL) thickness analysis and thicknesses for retinal nerve fiber layer (mRNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL) were obtained with 6 mm macular grid. Subfoveal cho-roidal thickness was measured from the outer portion of the hyperreflective line corresponding to the RPE to inner surface of the sclera using EDI mode of SD-OCT. The ARCA patients were defined as at least 1 eye had a choroidal thickness of less than 125 micron without significant macular and retinal pigment epithelium problems as described by Spaide. Fundus autofluorescence imaging demonstrated the intact retinal pigment epithelium. The patients with AMD, any retinovascular abnormalities, epiretinal membrane, glaucoma, myopia higher than 3 diopters, axial length higher than 25.00 mm, a history of vitreoretinal surgery, intravitreal injection, photodynamic therapy, and argon laser photocoagulation were excluded from the study. The mean pRNFL, mRNFL, mGCL and mIPL were compared between the two groups.
Results
There were no intergroup differences with regard to age, sex, best corrected visual acuity, intraocular pressure, and axial length (p value is higher than 0.05 for all). The mean age was 78±5 years in ARCA group and 77±6 years in the control group. The mean pRNFL thickness was 93.21± 10.45 in group 1, 98.29±8.11 in group 2 (p= 0.01). The mean mGCL thickness was 36.72±6.23in group 1, 41.22 ±3.70 in group 2 (p=0.001). The mean mIPL thickness was 31.32 ±3.59 in group 1 and 33.94 ±2.63 in group 2 (p=0.001). There were no difference in mean mRNFL values of both groups (p=0.2).
Conlusions
This study detected lower mean thicknesses of mGCL, mIPL and pRNFL of eyes with ARCA. The marked choroidal thinning in eyes with ARCA may be associated with the pathophysiology of glaucoma as the structural glaucoma indicators demonstrated thinner values than healthy controls which were age and axial length matched.
Financial Disclosure
none
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