Choroidal Changes in Cerebral Amyloid Angiopathy Studied by Optical Coherence Tomography Angiography

Background cerebral amyloid angiopathy (CAA) involves amyloid-β deposition in cerebral vessels. Its effects on the ocular circulation remain unclear. Using swept-source optical coherence tomography angiography (SS-OCTA), this study quantitatively characterized choroidal parameters in CAA patients and their correlation with MRI neuroimaging markers. Method CAA patients and matched controls were enrolled. We used SS-OCTA to obtain choroidal parameters including thickness, choriocapillaris flow density, choroidal vascular volume (CVV), and choroidal vascular index (CVI). The correlations between these parameters and CAA-specific neuroimaging markers on MRI were then analyzed. Results in the study comprising 23 eyes from 23 CAA patients and 23 eyes from 23 healthy controls, we interrogated choroidal parameters using SS-OCTA. The CAA group exhibited a significantly lower choriocapillaris flow density compared to controls (P < 0.05). Furthermore, this parameter showed a nominal inverse association with the burden of subcortical spot white matter hyperintensities, which did not survive correction for multiple comparisons (FDR-adjusted q > 0.05). Conclusion our study suggests that reduction in choriocapillaris density may serve as a potential cross-sectional biomarker for CAA, pending validation in longitudinal studies.