Choroidal vascular changes in age-related macular degeneration
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As an increasing age-related eye disease, age-related macular degeneration (AMD) is becoming a common cause of irreversible visual loss in elder population. The mechanism of AMD remains uncertain and covers a complex risk factors. Choroidal vascularity index (CVI) is a sensitive parameter obtained by enhanced depth imaging of optical coherence tomography which allows the choroid in more detail and accurate assessment in the pathogenesis of AMD. The objective of this current study is to evaluate choroidal structural alternations measured by CVI in AMD.We will review 4 English databases (PubMed, Embase, Cochrane Library, and Web of Science) from their inception until present to select eligible articles. English-language and case-control studies will be accepted. The data extraction content and quantitative analysis will be performed systematically by 2 independent authors. The primary outcome is the alternation of CVI in AMD. The secondary outcomes consist of choroidal thickness (CT), luminal area (LA), stromal area (SA), and total choroidal area (TCA). Subgroup analysis, sensitivity analysis, and publication bias will be performed to check the robustness of the pooled outcome data.Changes of quantitative parameters such as CVI will be obtained in patients with AMD.This study will elucidate alternations of choroidal vascular and stromal component in AMD and provide robust evidence on the pathophysiology of AMD.INPLASY.Keywords:
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The aim of this study was to investigate optical coherence tomography (OCT) and OCT angiography (OCTA) parameters in patients with neovascular age-related macular degeneration (nAMD) and macular neovascularization (MNV) type 1, type 2, and type 3.In this retrospective study, 105 treatment-naïve eyes of 105 patients (60 men and 45 women) with a definite diagnosis of active nAMD and MNV of different types and 105 frequency-matched age and gender healthy subjects were evaluated (61 men and 44 women). All subjects underwent a full ophthalmic examination and multimodal imaging assessment, including spectral domain (SD) OCT and OCTA. The main outcome measures were choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT), central macular thickness (CMT), and outer retina to choriocapillaris (ORCC) MNV flow area (ORCCFA).Significant differences were found in terms of CVI, CMT, and ORCCFA between MNV 1 and the two other groups. CVI was significantly different between MNV 1 and healthy control patients (p < 0.001) and between MNV 1 and MNV 2 (p < 0.001). ORCCFA and CMT were significantly different between MNV1 and MNV2 (p < 0.005). The difference in subfoveal CT between the three groups was not statistically significant (p = 0.458). A significant negative correlation was found between CVI and ORCCFA. Furthermore, CVI showed a positive correlation with subfoveal CT.
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A critical method of monitoring patients with neovascular age-related macular degeneration (AMD) being treated with anti-vascular endothelial growth factor (anti-VEGF) is optical coherence tomography (OCT), which uses low-coherence interferometry of light to examine the retina in vivo on a micrometer scale. 1 Recent advances in spectral-domain OCT make visualization of the choroid feasible.[4] It has been hypothesized that anti-VEGF may affect choroidal vasculature. 5The goal of this study is to evaluate the effect of anti-VEGF on choroidal thickness using spectral-domain OCT in treatment-naive subjects. MethodsTwenty-two patients (22 eyes) with neovascular AMD were identified prior to first-time treatment with anti-VEGF at New England Eye Center.All patients with concomitant ocular pathologies were excluded.Twenty age-matched healthy eyes were identified as a control group.This study was approved by the institutional review board of the Tufts Medical Center.Patients were imaged with spectral-domain OCT prior to first-time treatment with anti-VEGF therapy and again at 3, 6, and 12 months (Figure 1).Control eyes were imaged at the time of identification and 6 months later.The scan pattern used was Cirrus high-definition 1line raster (Carl Zeiss Meditec), which is a 6-mm line consisting of 4096 A-scans and 20 Bscans averaged together without tracking.
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Enhanced depth imaging spectral-domain optical coherence tomography ( EDI SD-OCT),based on the improvement of traditional frequency-domain OCT,is a new technology used to reflect the structure of the choroid.The images are obtained by positioning the SD-OCT device close enough to the eye to present an inverted representation of the fundus,and also can quantitatively measure the choroidal thickness.So far studies about this technology are focused on the changes of the choroidal thickness.By measuring the choroidal thickness,EDI SD-OCT can not only be used to explore the pathogenesis of the diseases such as high myopia,age-related macular degeneration,polypoidal choroidal vasculopathy,etc,but also be used to differentiate age-related macular degeneration,polypoidal choroidal vasculopathy,a variety number of choroidal tumors,etc.In addition,EDI SD-OCT can be used to observe the treatment effect such as choroidal neovascularization and Vogt-Koyanagi-Harada.
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optical coherence tomography; enhanced depth imaging; choroid; choroidal thickness
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Objective Age-related macular degeneration(ARMD)is the leading cause of central visual loss in the present. It is pathologic bases that the subfoveal choroidal neovascularization which is the formation of new blood vessels either between the retinal pigment epithelium and Bruch membrane.The macular photocoagulation has proved to be effective, but it had severe visual ocuity decrease within 12 months of follow-up. Transpupillary thermotherapy(TTT) is a technique which heat is delivered to the choroid and retinal pigment epithelium through the pupil using 810nm laser.The earliest investigation is to treat choroid melanoma and retinoblastoma. It is proved that TTT had effective for occult choroidal neovascularization suffer from ARMD resently and hadn't negative effect.
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Abstract Background Age-related macular degeneration (AMD) is the leading cause of severe irreversible visual impairment worldwide. The disease has a deep impact on the quality of life of affected person and represents a major socioeconomic challenge. Neovascular age-related macular degeneration (nAMD) is a rapidly progressing disease which impacts central vision. It is responsible for 90% of cases of AMD associated severe vision loss. Choroidal thicknening is hypothesized to occur in the active phase of neovascular AMD. On the other hand, multiple studies reported progressive choroidal thinning in nAMD. Aim to study the correlation between choroidal thickness, and the activity of choroidal neovascularization in cases of neovascular (wet) Age related macular degeneration using Spectral domain Ocular coherence tomography. Methodology Our study included 33 eyes of 30 participants subdivided into neovascular AMD group (23 eyes of 20 patients), and age matched control group (10 eyes of 10 participants). Spectral domain optical coherence tomography (Avanti RTVue XR AngioVue OCT (Optovue Inc, Fremont, USA) was used to measure central foveal thickness (CFT), and subfoveal choroidal thickness (SFCT) after conduction of complete ocular examination and history taking. Results Our study shows a significant decrease in subfoveal choroidal thickness in neovascular AMD group (157.82 + 68.67 µm) when compared to the age matched control group (266.9+ 48.37 µm) with (P value <0.001). But, we found no clinically significant difference in SFCT between active CNV (179.23 + 64.36 µm) and inactive CNV groups (136.4 + 72.97 µm) (P value = 0.19). Conclusion there is a significant thinning of choroid in nAMD in comparison to control. But no statistically significant difference in SFCT between active and inactive choroidal neovascular groups.
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