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Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study
  1. Lisa Toto1,
  2. Enrico Borrelli1,
  3. Rodolfo Mastropasqua2,
  4. Luca Di Antonio1,
  5. Emanuele Doronzo1,
  6. Paolo Carpineto1,
  7. Leonardo Mastropasqua1
  1. 1Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
  2. 2Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
  1. Correspondence to Dr Enrico Borrelli, Department of Ophthalmology, University G. D'Annunzio, Via dei Vestini, Chieti 66100, Italy; borrelli.enrico{at}


Aims To investigate associations between changes in retinal vessels and alterations detected by spectral domain optical coherence tomography (SD-OCT) scans in intermediate stage age-related macular degeneration (AMD).

Methods Thirty eyes of 30 patients with intermediate dry AMD were enrolled in the study. Of the cohort study, 15 eyes (changes-AMD group) showed OCT changes preceding the development of drusen-associated atrophy. A control group of healthy subjects was selected for statistical comparisons. All patients underwent an ophthalmologic evaluation, including OCT angiography (OCTA) and SD-OCT scans. Main outcome measures were superficial vessel density, deep vessel density, macular thickness.

Results Foveal macular thickness was 215.2±32.9 μm in changes-AMD patients and was significantly thinner than no changes-AMD patients (248.3±23.3 μm, p=0.002) and healthy subjects (268.1±19.2 μm, p<0.0001). Furthermore, in the parafoveal area, the thicknesses of both the inner retina and the outer retina were reduced in the changes-AMD group, after comparison with the two other groups. Parafoveal superficial vascular plexus flow density was 43.3±2.7% in changes-AMD patients and was decreased compared with the no changes-AMD group (48.7±3.3%, p=0.003) and healthy controls (50.4±6.1%, p=0.001). A direct correlation of the superficial plexus flow density with the inner retina parafoveal macular thickness (R2=0.761, p=0.028) was found.

Conclusions We demonstrated an association between SD-OCT signs and retinal blood supply in patients with intermediate AMD and we showed that patients with signs predicting development of geographic atrophy have a reduced flow in superficial vascular plexus and damage of the inner and the outer retina.

  • Macula
  • Imaging
  • Degeneration

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