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Choriocapillaris flow deficit associated with intraretinal hyperreflective foci in intermediate age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the choriocapillaris (CC) flow deficit (FD) beneath drusen associated with overlying intraretinal hyperreflective foci (HRF).

Methods

Patients with intermediate age-related macular degeneration (AMD) who had structural spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCTA) using the Cirrus HD-OCT with AngioPlex software were retrospectively evaluated. A 6 × 6-mm-volume scan was used for the SD-OCT and OCTA. Post-imaging processing steps included generation of drusen map, identification of HRF, and generation of a signal-compensated CC slab prior to binarization and CC FD computation. The CC OCTA image was aligned with the drusen + HRF map to define regions of interest for CC FD measurement. The CC was quantified below drusen with and without overlying HRF and within a 150-μm-wide ring surrounding the drusen (unaffected by potential HRF-related shadowing), and across the entire 6 × 6 macular region.

Results

Fifty-three eyes with intermediate AMD were included, 25 eyes with HRF, and 28 eyes with no HRF. The mean ± SD FD% over the whole 6 × 6 macular region was 41.1 ± 3.4 in eyes with HRF compared with 39.5 ± 3.5 in eyes without HRF (p = 0.001). The mean ± SD CC FD% below drusen with HRF (54.4 ± 9.3) was significantly greater than below drusen without HRF (49.6 ± 9.5; p = 0.001). There was a strong positive correlation between the quantity of HRF and the extent of the CC FD (Pearson correlation = 0.81).

Conclusion

Choriocapillaris flow deficits appear to be more severe in eyes with HRF and in particular directly below HRF. As HRF are thought to represent a higher risk or more advanced feature of intermediate AMD, these findings highlight the relationship between the severity of CC FD and overall severity of AMD.

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Author information

Authors and Affiliations

  1. Doheny Image Reading and Research Lab, Doheny Eye Institute, 1355 San Pablo Street, Suite 211, Los Angeles, CA, 90033, USA

    Liran Tiosano, Iksoo Byon, Ahmed Roshdy Alagorie, Yong-Sok Ji & Srinivas R. Sadda

  2. Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    Liran Tiosano, Iksoo Byon, Ahmed Roshdy Alagorie, Yong-Sok Ji & Srinivas R. Sadda

  3. Department of Ophthalmology, Hadassah-Hebrew University Medical Center, and the Hebrew University – Hadassah School of Medicine, Jerusalem, Israel

    Liran Tiosano

  4. Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea

    Iksoo Byon

  5. Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt

    Ahmed Roshdy Alagorie

  6. Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea

    Yong-Sok Ji

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Correspondence to Srinivas R. Sadda.

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Conflict of interest

Dr. Sadda receives research funding from Allergan, Carl Zeiss Meditec, Genentech, Optos, and Topcon and serves as a consultant to Allergan, CenterVue, Genentech, Heidelberg Engineering, Iconic, Novartis, Optos, and Oxurion. Other authors have no financial disclosures.

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Tiosano, L., Byon, I., Alagorie, A.R. et al. Choriocapillaris flow deficit associated with intraretinal hyperreflective foci in intermediate age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 258, 2353–2362 (2020). https://doi.org/10.1007/s00417-020-04837-y

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  • DOI: https://doi.org/10.1007/s00417-020-04837-y

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