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CHOROIDAL THICKNESS, VASCULAR FACTORS, AND AGE-RELATED MACULAR DEGENERATION: The ALIENOR Study

Gattoussi, Sarra, MD, PhD*,†; Cougnard-Grégoire, Audrey, PhD*; Korobelnik, Jean-François, MD*,†; Rougier, Marie-Bénédicte, MD*,†; Delyfer, Marie-Noëlle, MD*,†; Schweitzer, Cédric, MD*,†; Le Goff, Mélanie, MSc*; Merle, Bénédicte M.J., PhD*; Dartigues, Jean-François, MD*; Delcourt, Cécile, PhD*

doi: 10.1097/IAE.0000000000002237
Original Study: PDF Only

Purpose: To study the associations of subfoveal choroidal thickness with vascular risk factors and age-related macular degeneration.

Methods: Two hundred sixty-one participants of the Alienor study had gradable enhanced-depth imaging optical coherence tomography scans of the macula and available data on vascular and genetic risk factors (assessed through face-to-face interview and fasting blood samples) and age-related macular degeneration status (assessed from retinal photographs and optical coherence tomography). Subfoveal choroidal thickness was measured manually on one horizontal scan passing through the fovea.

Results: In a multivariate mixed linear model, subfoveal choroidal thickness was independently associated with age greater than 80 years (−21.77 μm, P = 0.02), axial length (−21.77 μm, P < 0.0001), heavy smoking (≥20 pack-years: −24.89 μm, P = 0.05), fasting blood glucose higher than 7 mmol/L (−53.17 μm, P = 0.02), and lipid-lowering treatment (+18.23, P = 0.047). After multivariate adjustment for age, sex, axial length, and vascular and genetic risk factors, subfoveal choroidal thickness was thinner in eyes with central hyperpigmentation (−45.39 μm, P = 0.006), central hypopigmentation (−44.99 μm, P = 0.001), and central pigmentary abnormalities (−44.50 μm, P = 0.001), but not in eyes with late age-related macular degeneration (−18.05 μm, P = 0.33) or soft drusen.

Conclusion: These findings indicate a relationship between vascular risk factors and choroidal thinning and suggest an early involvement of the choroid in the pathogenesis of age-related macular degeneration.

In this study of 261 French elderly subjects, subfoveal choroidal thickness was independently associated with age, axial length, smoking, fasting blood glucose, and lipid lowering therapy. It was significantly thinner in eyes with pigmentary abnormalities, but not in those with soft drusen or late age-related macular degeneration.

*University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, UMR 1219, Bordeaux, France; and

Service d'Ophtalmologie, CHU de Bordeaux, Bordeaux, France.

Reprint requests: Cécile Delcourt, PhD, Inserm, U1219- Bordeaux Population Health Research Center, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France; e-mail: cecile.delcourt@u-bordeaux.fr

Laboratoires Théa (Clermont-Ferrand, France), Université de Bordeaux (Bordeaux, France), Fondation Voir et Entendre (Paris, France), Agence Nationale de la Recherche (2010-PRSP-011), CNSA (Caisse Nationale pour la Solidarité et l'Autonomie) (Paris, France). Laboratoires Théa participated in the design of the study, but none of the sponsors participated in the collection, management, statistical analysis and interpretation of the data, or in the preparation, review, or approval of the present manuscript.

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.