The Umbra and the Penumbra: Longitudinal Effects of Geographic Atrophy in AMD on the Outer Choroid by Imaging Analysis and Histopathological Correlation

Enrico Borrelli ^1,2, Francesco Cappellani ^3,4, Jose S Pulido ^3,4

⁰Department of Surgical Sciences, University of Turin, Turin, Italy.

Investigative Ophthalmology & Visual Science +

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December 2, 2024

View abstract on PubMed

Summary

Outer choroidal vessels shrink over time in geographic atrophy (GA) areas of the eye. This vessel loss accelerates when GA progresses, suggesting tight biological regulation.

Area Of Science

Ophthalmology
Retinal Diseases
Vascular Biology

Background

Geographic atrophy (GA) is a leading cause of vision loss in age-related macular degeneration (AMD).
Understanding the changes in choroidal vasculature is crucial for managing GA progression.

Purpose Of The Study

To quantify regional changes in outer choroidal vessels in patients with GA.
To correlate in vivo findings with histopathological data from donor eyes.

Main Methods

Structural optical coherence tomography (OCT) scans were performed on 35 participants with GA over one year.
Quantitative measurements of outer choroidal vessel area were taken in the GA region, a surrounding border, and beyond.
Histopathological analysis of choroidal flat-mounts was conducted for correlation.

Main Results

A statistically significant decrease in outer choroidal vessel area was observed within the GA region over 12 months.
Choroidal shrinking was more pronounced in eyes where GA progressed at the border.
Histopathology confirmed outer choroidal vessel loss, particularly in the GA area.

Conclusions

Outer choroidal vessels diminish over time within GA areas.
Progressive GA is associated with accelerated outer vessel reduction.
These vascular changes may be regulated by paracrine factors.