In Vivo Quantification of Bruch's Membrane Changes in Angioid Streaks and Neovascular Age-related Macular...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Macular Degeneration

Background:

• Angioid streaks (AS) are associated with various systemic and ocular conditions.
• Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss in the elderly.
• Differentiating AS-associated MNV from nAMD is crucial for appropriate management.

Purpose of the Study:

• To investigate Bruch's membrane (BrM) morphology in AS-associated MNV and nAMD.
• To compare multimodal imaging features between AS-MNV and nAMD.
• To evaluate diagnostic biomarkers for differentiating these conditions.

Main Methods:

• Retrospective cohort study of treatment-naïve eyes with MNV secondary to AS or nAMD.
• Multimodal imaging including indocyanine green angiography (ICGA) and optical coherence tomography (OCT).
• Analysis of BrM morphology, MNV area, speckled hypofluorescent areas (SHA), and BrM reflectivity index (BRI).

Main Results:

• AS-associated MNV showed larger MNV area and more frequent late-phase SHA on ICGA compared to nAMD.
• Subfoveal choroidal thickness was lower in AS-MNV.
• BrM undulation and BRI were significantly higher in AS-MNV, with BRI demonstrating good diagnostic performance.

Conclusions:

• AS-associated MNV exhibits distinct imaging features compared to nAMD, suggesting underlying BrM alterations.
• BrM-derived biomarkers, particularly BRI, show potential for differentiating AS-MNV from nAMD.
• These findings aid in understanding AS pathophysiology and improving diagnostic accuracy.