Original articleDelayed Patchy Choroidal Filling in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)
Section snippets
Methods
Institutional review board approval was obtained from the University of Pennsylvania and all participating CATT clinical centers. Each participant provided written informed consent that complied with the Health Insurance Portability and Accountability Act before entry into the study. Details regarding the methodology of the CATT study, an interventional double-masked trial, have been reported previously and also can be reviewed at ClinicalTrials.gov (identifier, NCT00593450).27 Below is a
Baseline Characteristics of Study Participants
Among the 1118 graded eyes, 973 (87.0%) were gradable for delayed patchy choroidal filling, and 75 (7.7%) of these had evidence of delayed patchy choroidal filling at baseline. Figure shows a typical case of delayed patchy choroidal filling.
The mean age was 79.3 years in patients with baseline delayed patchy choroidal filling and 78.8 years in patients with normal baseline choroidal filling; this difference was not statistically significant (difference [Δ], 0.5; 95% CI, −1.3 to 2.2; P = .62;
Discussion
The presence of delayed patchy choroidal filling was a relatively rare finding, observed at baseline in less than 8% of participants. In comparison with baseline, there was a small, but statistically significant, increase in delayed patchy choroidal filling after 1 year of treatment, suggesting a more delayed choroidal filling time at 1 year. Whether this is an effect of the anti-VEGF treatment or an effect of aging, which is known to be associated with decreased choroidal blood flow,29 cannot
Dina Y. Gewaily, MD, MSc is a rising second year fellow in Vitreo-retinal Disease and Surgery at the Scheie Eye Institute at the University of Pennsylvania, where she also completed her residency in ophthalmology. She is a graduate of Brown University's 8 year Program in Liberal Medical Education. At the Children's Hospital of Philadelphia, she is assistant surgeon in the gene therapy trials for Leber's Congenital Amaurosis. Her interests include clinical trials, teaching, and international
References (32)
- et al.
Presumed macular choroidal watershed vascular filling, choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration
Am J Ophthalmol
(1998) - et al.
Metabolic physiology in age related macular degeneration
Prog Retin Eye Res
(2011) - et al.
Evolution of age-related macular degeneration with choroidal perfusion abnormality
Am J Ophthalmol
(1992) - et al.
Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration
Am J Ophthalmol
(1999) - et al.
Ocular blood flow velocity in age-related macular degeneration
Ophthalmology
(1995) The pathogenesis of age-related macular degeneration
Am J Ophthalmol
(2008)- et al.
Choroidal ischemia
Am J Ophthalmol
(1982) - et al.
A computerized method of visual acuity testing: adaptation of the early treatment of diabetic retinopathy study testing protocol
Am J Ophthalmol
(2003) - et al.
Intravitreal Ranibizumab may induce retinal arteriolar vasoconstriction in patients with neovascular age-related macular degeneration
Ophthalmol
(2009) - et al.
Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration: 12-months results
Ophthalmology
(2012)
Choroidal blood flow and progression of age-related macular degeneration in the fellow eye in patients with unilateral choroidal neovascularization
Invest Ophthalmol Vis Sci
Pulsatile ocular blood flow in asymmetric exudative age related macular degeneration
Br J Ophthalmol
Indocyanine green angiography of choroidal neovascular membranes
Ophthalmologica
Topographic variation of the choroidal watershed zone and its relationship to neovascularization in patients with age-related macular degeneration
Acta Ophthalmol
Foveolar choroidal circulation and choroidal neovascularization in age-related macular degeneration
Invest Ophthalmol Vis Sci
Pulsatile ocular blood flow and choroidal blood flow in age-related macular degeneration
Nihon Ganka Gakkai Zasshi
Cited by (7)
Pathogenesis of myopic choroidal neovascularization: A systematic review and meta-analysis
2023, Survey of OphthalmologyA Revised Hemodynamic Theory of Age-Related Macular Degeneration
2016, Trends in Molecular MedicineCitation Excerpt :The concept that choroidal hemodynamics contribute to AMD progression is supported by recent clinical and experimental evidence. Altered choroidal hemodynamic parameters, such as reduced choroidal blood flow [12–16] and focal hypoperfusion [17], have been observed in human AMD. Analyses of postmortem human donor eyes have found that areas of decreased choriocapillaris density extends beyond the margin of RPE loss [18–21], which implies that choriocapillaris hemodynamic changes precede the manifestation of advanced AMD.
Dina Y. Gewaily, MD, MSc is a rising second year fellow in Vitreo-retinal Disease and Surgery at the Scheie Eye Institute at the University of Pennsylvania, where she also completed her residency in ophthalmology. She is a graduate of Brown University's 8 year Program in Liberal Medical Education. At the Children's Hospital of Philadelphia, she is assistant surgeon in the gene therapy trials for Leber's Congenital Amaurosis. Her interests include clinical trials, teaching, and international ophthalmology.
Dr Juan E. Grunwald, MD, Professor of Ophthalmology at the University of Pennsylvania, is the Director of the Vivian Lasko Retinal Vascular Research Laboratory at the Scheie Eye Institute dedicated to research on ocular vascular physiology and pathology. One of his main interests is the elucidation of the role of blood flow abnormalities in the development of eye diseases. Dr Grunwald is a clinician, researcher and educator who specializes in the treatment of retinal diseases.