Optical Coherence Tomography Angiography in Age-Related Macular Degeneration

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Understanding the microvascular changes, including choriocapillaris alterations and macular neovascularization (MNV), is critical for managing AMD.
• Optical coherence tomography angiography (OCTA) offers non-invasive visualization of these microvascular changes.

Purpose of the Study:

• To review and synthesize current evidence on OCTA's role in assessing choriocapillaris and MNV in AMD.
• To focus on disease progression and clinical implications of OCTA findings.
• To explore the utility of OCTA-derived biomarkers for AMD management.

Main Methods:

• Selective review of specialized literature focusing on qualitative and quantitative OCTA analyses in AMD.
• Emphasis on choriocapillaris flow deficits, MNV morphology and maturity, and associations with AMD structural changes.
• Inclusion of studies utilizing both spectral-domain and swept-source OCTA systems.

Main Results:

• OCTA visualizes choriocapillaris and MNV alterations throughout AMD progression.
• Early AMD shows localized choriocapillaris flow deficits; advanced stages exhibit significant damage, especially near geographic atrophy and MNV.
• Quantitative OCTA biomarkers correlate strongly with disease stage, progression risk, and treatment response; MNV maturity impacts surrounding choriocapillaris.

Conclusions:

• A strong link exists between choriocapillaris dysfunction, MNV development, and AMD progression.
• OCTA provides valuable biomarkers for prognostic assessment and treatment monitoring in AMD.
• Standardization of OCTA protocols and analysis is needed for routine clinical integration.