May 31, 2019 Conference

  


Title
Spatial analysis of choriocapillaris flow deficits in staged dry AMD using swept-source OCTA

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Author(s)
Phillip Braun, New England Eye Center (Presenter)
Nihaal Mehta
Isaac Gendelman, New England Eye Center
Dr. Agha Yasin Alibhai, New England Eye Center, Tufts Medical Center
Mr. Eric Moult, Research Laboratory of Electronics / Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA
Akihiro Ishibazawa, New England Eye Center
Osama` Soror, New England Eye Center
Dr. Caroline Baumal, NEEC New England Eye Center
Dr. Andre Witkin, Tufts Medical Center
Dr. James Fujimoto, Research Laboratory of Electronics / Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA
Dr. Jay Duker, New England Eye Center
Dr. Nadia Waheed, Tufts New England Eye Center
Abstract

This study aimed to investigate (1) whether dry AMD stage has an independent association with macular CC perfusion, and (2) how this association (if any) varies by region.  3x3 mm and 6x6 mm swept-source OCTA images from eyes with early, intermediate, and advanced dry AMD (61 eyes from 44 patients) were analyzed using an algorithm to account for drusen shadowing followed by binarization and particle analysis to assess global and regional flow deficit metrics (flow deficit %, average flow deficit size).  Analyzed regions were defined by concentric areas centered on the fovea: a 1 mm diameter circle, 1.5 mm diameter ring, 2.5 mm diameter circle, 2.5 mm diameter ring, and whole image (3x3 mm images); a 1 mm diameter circle, 3 mm diameter ring, 5 mm diameter circle, 5 mm diameter ring, and whole image (6x6 mm images).  Data were analyzed using the Generalized Estimating Equations (GEE) approach, which can account for correlation among fellow eyes.

The independent association of stage with flow deficit metrics was statistically significant (p ? .05) only in more peripheral regions of the macula: 5 mm ring (flow deficit %); 3 mm ring, 5 mm circle, 5 mm ring, and whole 6x6 mm area (average flow deficit size).  The association of age with flow deficit metrics was significant in all regions at both image sizes, except for average flow deficit size in 3x3 mm images (only the 1.5 mm ring showed significance).  There was no significant association of eye side with flow deficit metrics in any region of analysis. 

To address the central questions of this study: (1) there seems to be an independent association between dry AMD stage and macular CC perfusion; (2) this association is most prominent in more peripheral regions of the macula.