Variation of Retinal and Choroidal Vasculatures in Patients With Age-Related Macular Degeneration.

Purpose: To investigate variations in chorioretinal vasculatures in fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD).

Methods: We included fellow eyes of consecutive patients with unilateral nAMD from swept source optical coherence tomography (SS-OCT) angiography database. Vascular and nonvascular indices were determined based on SS-OCT and SS-OCT angiography images. Variation of the vascular or nonvascular index was compared between fellow eyes with and without early AMD.

Results: In 146 fellow eyes, 88 (60.3%) had early AMD and 58 (39.7%) had a normal fundus. Vascular density (VD) values of the superficial and deep retinal capillary plexus and choriocapillaris were smaller in eyes with early AMD than in those without (P < 0.001, P = 0.001, P = 0.006, respectively). Flow void area in choriocapillaris was greater in eyes with early AMD than those without (P = 0.015). In 88 fellow eyes with early AMD, vascular indices of the retina were correlated with those of choroid while nonvascular indices were not. Fellow eyes of patients with classic exudative AMD had greater foveal avascular zone area and smaller VD values of the deep retinal capillary plexus than those with polypoidal choroidal vasculopathy (P < 0.001, P = 0.004).

Conclusions: In addition to vascular insufficiency in the choroid or choriocapillaris, retinal vascular alteration was apparent in eyes with early AMD. It may suggest that retinal vessels were involved in the pathogenesis of AMD even while changes in nonvascular components of the retina were not yet apparent.