title: Choriocapillaris Nonperfusion is Associated With Poor Visual Acuity in Eyes With Reticular Pseudodrusen.
abstract: OBJECTIVE
  To study choriocapillaris blood flow in age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA) and study its correlation to visual acuity (VA) in eyes with reticular pseudodrusen (RPD) vs those with drusen without RPD (drusen).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients with either drusen or RPD in early AMD underwent OCTA imaging of the superior, inferior, and/or nasal macula. We quantified "percent choriocapillaris area of nonperfusion" (PCAN) in eyes with RPD vs those with drusen. We assessed the repeatability of PCAN and its correlations with VA.
  
  
  RESULTS
  Twenty-nine eyes of 26 patients with RPD and 21 eyes of 16 age-matched AMD patients with drusen were included. Qualitatively, the choriocapillaris in areas with RPD showed focal dark regions without flow signal on OCTA (nonperfusion). The repeatability coefficient of PCAN was 0.49%. Eyes with RPD had significantly greater PCAN compared with eyes with drusen (7.31% and 3.88%, respectively; P < .001). We found a significant correlation between PCAN and VA for the entire dataset (r = 0.394, P = .005). When considering eyes with RPD separately, this correlation was stronger (r = 0.474, P = .009) but lost significance when considering eyes with drusen separately (r = 0.175, P = .45).
  
  
  CONCLUSIONS
  Eyes with RPD have significantly larger areas of choriocapillaris nonperfusion compared with eyes with drusen and no RPD. The correlation between PCAN and VA in this RPD population provides a potential mechanistic explanation for vision compromise in RPD compared with other forms of drusen in AMD.
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors: Peter L
authors: PL
authors: Nesper
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Medical Scientist Training Program, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Chciago, Illinois.
authors: Brian T
authors: BT
authors: Soetikno
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: afawzimd@gmail.com.
authors: Amani A
authors: AA
authors: Fawzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002196:Capillaries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002829:Choroid / Q000098:blood supply*; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D012039:Regional Blood Flow / Q000502:physiology*; D015593:Retinal Drusen / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity