CHOROIDAL THICKNESS AND VASCULARITY VARY WITH DISEASE SEVERITY AND SUBRETINAL DRUSENOID DEPOSIT PRESENCE IN NONADVANCED AGE-RELATED MACULAR DEGENERATION.

To investigate how choroidal features vary with age-related macular degeneration (AMD) severity in early-intermediate disease. One hundred fifty-one eyes of 151 participants >50 years with no to intermediate AMD were analyzed with enhanced depth imaging optical coherence tomography. Mean macular choroidal thickness (CT), choroidal vascular thickness (CV), and choroidal vascularity index (CVI) were determined, and statistical associations were calculated. Decreased CT and CV were associated with increased axial length (+30 and +14 μm/mm, respectively; P < 0.0001 each), whereas decreased CVI was associated with increased age (+0.1%/year; P = 0.004). Compared with eyes with no/early AMD (Group 0), eyes with large drusen without late AMD in the fellow eye (Group 1) showed increased CV and CVI (+22 μm, P = 0.03 and +2.2%, P = 0.02, respectively). However, eyes with large drusen and late AMD in the fellow eye (Group 2) resembled Group 0. Eyes with subretinal drusenoid deposits demonstrated lower mean CT/CV/CVI than Group 0 (−57 μm, P = 0.02; −31 μm, P = 0.02; −3.6%, P = 0.007). Early AMD progression seems associated with biphasic alterations in choroidal dimensions, increasing during early drusen formation but decreasing thereafter. Subretinal drusenoid deposits are independently associated with marked reductions in all choroidal parameters. Changes in choroidal vascular anatomy may drive or reflect the pathobiology of AMD progression.

研究脉络膜特征在早中期年龄相关性黄斑变性（AMD）病情严重程度不同时如何变化。 对151名50岁以上无AMD到中期AMD的参与者的151只眼睛，采用增强深部成像光学相干断层扫描进行分析。测定平均黄斑脉络膜厚度（CT）、脉络膜血管厚度（CV）和脉络膜血管指数（CVI），并计算统计学关联。 CT和CV降低与眼轴长度增加相关（分别为每毫米+30和+14μm；每项P < 0.0001），而CVI降低与年龄增加相关（每年+0.1%；P = 0.004）。与无/早期AMD的眼睛（0组）相比，对侧眼无晚期AMD的大玻璃膜疣眼（1组）显示CV和CVI增加（分别为+22μm，P = 0.03和+2.2%，P = 0.02）。然而，对侧眼有大玻璃膜疣且有晚期AMD的眼睛（2组）与0组相似。视网膜下玻璃膜疣样沉积物眼的平均CT/CV/CVI低于0组（分别为 -57μm，P = 0.02； -31μm，P = 0.02； -3.6%，P = 0.007）。 早期AMD进展似乎与脉络膜尺寸的双相改变有关，在早期玻璃膜疣形成时增加，之后降低。视网膜下玻璃膜疣样沉积物与所有脉络膜参数的显著降低独立相关。脉络膜血管解剖结构的变化可能推动或反映AMD进展的病理生物学。