Original StudySWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS CHORIOCAPILLARIS ALTERATIONS IN EYES WITH NASCENT GEOGRAPHIC ATROPHY AND DRUSEN-ASSOCIATED GEOGRAPHIC ATROPHYMoult, Eric M. BSc; Waheed, Nadia K. MD, MPH; Novais, Eduardo A. MD; Choi, WooJhon PhD; Lee, ByungKun MEng; Ploner, Stefan B. BSc; Cole, Emily D. BSc; Louzada, Ricardo N. MD; Lu, Chen D. MSc; Rosenfeld, Philip J. MD, PhD; Duker, Jay S. MD; Fujimoto, James G. PhDAuthor Information *Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts; †New England Eye Center, Tufts Medical Center, Boston, Massachusetts; ‡Department of Ophthalmology, Federal University of São Paulo, School of Medicine, São Paulo, Brazil; §Department of Computer Science, Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; ¶Department of Ophthalmology, Federal University of Goiás, Goiânia, Brazil; and **Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Reprint requests: James G. Fujimoto, Dept of Electrical Engineering and Computer Science and Research Laboratory of Electronics, 77 Massachusetts Ave., Cambridge, MA 02139: email: [email protected] Supported in part by a grant from the Macula Vision Research Foundation, New York, National Institute of Health (NIH R01-EY011289-29, R44-EY022864, R01-CA075289-16, FA9550-15-1-0473, and FA9550-12-1-0499), and the Champalimaud Foundation. E. A. Novais and R. N. Louzada are researchers supported by CAPES Foundation, Ministry of Education of Brazil, Brasilia, DF, Brazil. J. S. Duker is a consultant for and receives research support from Carl Zeiss Meditec and OptoVue. N. K. Waheed was a consultant for Iconic therapeutics, served the speaker's bureau for Thrombogenics and received research support from Carl Zeiss Meditec, Inc. P. J. Rosenfeld has received research funding and speaker fees from Carl Zeiss Meditec. J. G. Fujimoto received royalties from intellectual property owned by the Massachusetts Institute of Technology and licensed to Carl Zeiss Meditec Inc, Optovue Inc; stock options—Optovue Inc. The remaining authors have no conflicting interests to disclose. Retina: December 2016 - Volume 36 - Issue - p S2-S11 doi: 10.1097/IAE.0000000000001287 Buy Metrics AbstractIn Brief Purpose: To investigate choriocapillaris (CC) alteration in patients with nascent geographic atrophy (nGA) and/or drusen-associated geographic atrophy (DAGA) using swept-source optical coherence tomography angiography (OCTA). Methods: A 1,050-nm wavelength, 400 kHz A-scan rate swept-source optical coherence tomography prototype was used to perform volumetric swept-source optical coherence tomography angiography over 6 mm × 6 mm fields of view in patients with nGA and/or DAGA. The resulting optical coherence tomography (OCT) and OCTA data were analyzed using a combination of en face and cross-sectional techniques. Variable interscan time analysis (VISTA) was used to differentiate CC flow impairment from complete CC atrophy. Results: A total of 7 eyes from 6 patients (mean age: 73.8 ± 5.7 years) were scanned. Seven areas of nGA and three areas of DAGA were identified. Analysis of cross-sectional OCT and OCTA images identified focal alterations of the CC underlying all seven areas of nGA and all three areas of DAGA. En face OCTA analysis of the CC revealed diffuse CC alterations in all eyes. Variable interscan time analysis processing suggested that the observed CC flow alterations predominantly corresponded to flow impairment rather than complete CC atrophy. Conclusion: The OCTA imaging of the CC revealed focal CC flow impairment associated with areas of nGA and DAGA, as well as diffuse CC flow impairment throughout the imaged field. En face OCT analysis should prove useful for understanding the pathogenesis of nGA and DAGA and for identifying the formation of nGA and DAGA as endpoints in therapeutic trials. Swept-source optical coherence tomography angiography reveals choriocapillaris alterations in eyes with nascent geographic atrophy and drusen-associated atrophy. © 2016 by Ophthalmic Communications Society, Inc.