title: Presumed macular choroidal watershed vascular filling, choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the possible association of presumed macular choroidal watershed vascular filling (PMWF), choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration.
  
  
  METHODS
  In a retrospective study, we evaluated 74 randomly selected indocyanine green videoangiograms of 74 patients with age-related macular degeneration. We also reviewed the charts of 20 randomly selected, age-matched control patients without age-related macular degeneration, initially referred for uniocular conditions, and subsequently performed indocyanine green videoangiography on their normal fellow eyes. We evaluated these videoangiograms for the presence of PMWF, manifesting as characteristic early choroidal hypofluorescence and its relation to choroidal neovascularization when present. Additionally, the incidence of hypertension, coronary artery disease, peripheral vascular disease, and diabetes mellitus was determined.
  
  
  RESULTS
  Forty-one (55.4%) of 74 patients with age-related macular degeneration vs three (15.0%) of 20 normal control patients exhibited PMWF on indocyanine green videoangiography (P = .0014). Of the 61 patients with age-related macular degeneration and choroidal neovascularization, 36 (59.0%) exhibited PMWF on videoangiography. Associated choroidal neovascularization arose from the PMWF zone in 33 (91.7%) of these cases. Hypertension was observed in 24 (58.5%) of 41 patients with age-related macular degeneration and PMWF vs nine (27.3%) of 33 patients with age-related macular degeneration who did not exhibit PMWF (P = .007).
  
  
  CONCLUSIONS
  An increased incidence of PMWF occurs in patients with age-related macular degeneration with a possible predisposition for the development of associated choroidal neovascularization. Additionally, PMWF may be accentuated by associated hypertensive choroidal microvascular insult.
authors.affiliation: Department of Ophthalmology, Touro Infirmary, New Orleans, Louisiana, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Ross
authors.forename: J M
authors.initials: JM
authors.lastname: Barofsky
authors.forename: G
authors.initials: G
authors.lastname: Cohen
authors.forename: W B
authors.initials: WB
authors.lastname: Baber
authors.forename: S W
authors.initials: SW
authors.lastname: Palao
authors.forename: K A
authors.initials: KA
authors.lastname: Gitter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D007208:Indocyanine Green; D008266:Macula Lutea / Q000098:blood supply* / Q000473:pathology; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications* / Q000473:pathology; D011897:Random Allocation; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000150:complications* / Q000473:pathology
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green