Decreased arterial dye-filling and venous dilation in the macular choroid associated with age-related macular degeneration.
OBJECTIVE
To compare the angioarchitecture of choroidal arteries and veins in patients with age-related macular degeneration (AMD) to the angioarchitecture of age-matched normal subjects using indocyanine green (ICG) angiography.


METHODS
ICG angiography was performed in 35 consecutive AMD patients and 18 normal age-matched volunteers with a fundus ICG camera. ICG video images, including the arterial and venous phases, were quantitatively analyzed using image analyzing software.


RESULTS
In patients with AMD, the choroidal arterioles are dilated, fewer, run a straighter course, and possess fewer bifurcations. The number of choroidal arteries and the macular fluorescent intensity in the arterial phase of choroidal filling was significantly less in patients with AMD as compared to age-matched normal controls (P = 0.008). The mean and maximum caliber of choroidal veins in the macula was dilated in AMD eyes than in age-matched normal control eyes (P < 0.001). There was no statistically significant difference in arterial dye filling or venous caliber observed in AMD eyes, with or without choroidal neovascular membrane (CNV).


CONCLUSIONS
Choroidal arterial perfusion in the macula was significant decreased in eyes with AMD with and without CNV, and was associated with choroidal venous dilation. These observations implicate poor choroidal perfusion of the macula in the pathogenesis of AMD.
Mori
Keisuke
K
Department of Ophthalmology, Saitama Medical School, Iruma, Saitama, Japan. keisuke@saitama-med.ac.jp
Gehlbach
Peter L
PL
Ito
Yoko Nishiyama
YN
Yoneya
Shin
S
D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology; D002199:Capillary Permeability; D016022:Case-Control Studies; D002829:Choroid / Q000098:blood supply*; D020256:Choroidal Neovascularization / Q000503:physiopathology*; D004396:Coloring Agents; D004108:Dilatation, Pathologic; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea; D008268:Macular Degeneration / Q000503:physiopathology*; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D014680:Veins / Q000473:pathology
D004396:Coloring Agents; D007208:Indocyanine Green