Choriocapillaris Changes in Myopic Macular Degeneration

Area of Science:

• Ophthalmology
• Retinal Imaging
• Vascular Biology

Background:

• Myopic macular degeneration (MMD) is a leading cause of irreversible vision loss.
• A thinner choroid is linked to increased MMD severity.
• Understanding choriocapillaris (CC) changes is crucial for MMD pathogenesis.

Purpose of the Study:

• To analyze choriocapillaris (CC) alterations in patients with MMD.
• To compare CC thickness and CC flow deficit in MMD patients versus controls.

Main Methods:

• Cross-sectional study comparing high myopes with MMD (grade 2) to controls.
• Utilized swept-source optical coherence tomography angiography (SS-OCTA) for CC imaging.
• Quantified CC mean thickness and CC flow deficit percent (CC FD%) using advanced imaging analysis.

Main Results:

• Patients with MMD exhibited significantly reduced CC thickness (66% lower) compared to controls.
• CC flow deficit percent (CC FD%) was substantially higher (237% greater) in MMD patients.
• These alterations were observed even in MMD patients with good visual acuity.

Conclusions:

• Grade 2 MMD patients with good visual acuity demonstrate significant CC alterations.
• Reduced CC thickness and increased CC FD% suggest impaired choriocapillaris perfusion.
• These findings support a role for CC perfusion defects in the pathogenesis of MMD.