Choriocapillaris Flow Signal Deficits Are Associated With AMD Onset and Early Progression Over Three Years: ALSTAR2...

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Impaired transport in the choriocapillaris may contribute to AMD pathogenesis.
• Choriocapillaris flow signal deficits (CCFD%) are a potential marker of this impairment.

Purpose of the Study:

• To investigate the association between baseline CCFD% and the onset/progression of AMD.
• To determine if CCFD% predicts AMD progression over a 3-year follow-up period.

Main Methods:

• Participants aged ≥60 with normal macula, early AMD (eAMD), or intermediate AMD (iAMD) were classified using the AREDS system.
• Spectral-domain optical coherence tomography angiography (OCTA) quantified CCFD% in the central subfield (CS), inner ring (IR), and outer area (OA).
• Baseline CCFD% was compared between eyes that remained stable and those that progressed over 3 years.

Main Results:

• Of 332 eyes, 14.5% progressed over 3 years.
• Progressing eyes showed significantly higher baseline CCFD% in the CS and IR compared to stable eyes.
• This association was primarily observed in eyes with eAMD, not in normal or iAMD eyes.

Conclusions:

• Baseline CCFD% in the central subfield and inner ring is associated with AMD progression in early stages.
• The spatial specificity suggests a role for the fovea in AMD progression related to impaired transport.
• CCFD% may serve as an early indicator of AMD progression.