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Takasago, Yukari, MD*; Shiragami, Chieko, MD*; Kobayashi, Mamoru, MD*; Osaka, Rie, MD*; Ono, Aoi, MD*; Yamashita, Ayana, MD*; Tsujikawa, Akitaka, MD; Hirooka, Kazuyuki, MD*

doi: 10.1097/IAE.0000000000001980
Original Study: PDF Only

Purpose: To compare the areas of choriocapillaris (CC) nonperfusion and macular atrophy (MA) in treated exudative age-related macular degeneration.

Methods: This was a prospective, observational, cross-sectional study. Forty-four eyes exhibiting MA (42 patients with age-related macular degeneration), with a dry macula, underwent fundus autofluorescence and optical coherence tomography angiography. The area of MA detected by fundus autofluorescence and CC nonperfusion detected by optical coherence tomography angiography was measured using image analysis software. The rates of concordance between the MA and CC nonperfusion areas were calculated. We qualitatively and quantitatively compared the areas of MA and CC nonperfusion in age-related macular degeneration eyes.

Results: The mean areas of MA and CC nonperfusion were 5.95 ± 4.50 mm2 and 10.66 ± 7.05 mm2, respectively (paired t-test, P < 0.001). In 39 eyes (88.6%), the CC nonperfusion area was larger than the MA area, and the mean CC nonperfusion area was significantly larger than the mean MA area. Fundus autofluorescence matching optical coherence tomography angiography showed that the CC nonperfusion area was almost included in the MA area. The mean concordance rate for the MA area inside the CC nonperfusion area was 87.7 ± 13.9%.

Conclusion: The MA and CC nonperfusion areas markedly overlapped. The area of CC nonperfusion correlated with the MA area. Choroidal ischemia might be involved in the pathogenesis of MA in treated age-related macular degeneration.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The area of choriocapillaris nonperfusion on optical coherence tomography angiography correlated with the area of macular atrophy on fundus autofluorescence in eyes with exudative age-related macular degeneration. Choroidal ischemia might be involved in macular atrophy in treated age-related macular degeneration.

*Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan; and

Department of Ophthalmology and Visual Sciences, Kyoto University Faculty of Medicine, Kyoto, Japan.

Reprint requests: Chieko Shiragami, MD, Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe Miki-cho, Kagawa 761-0793, Japan; e-mail:

A. Tsujikawa received a funding from Pfizer (Tokyo, Japan), Bayer (Whippany, NJ), Novartis (Tokyo, Japan), Santen (Osaka, Japan), Senju, (Osaka, Japan), Alcon (Tokyo, Japan), AMO Japan (Tokyo, Japan), Hoya (Tokyo, Japan), Kowa (Nagoya, Japan), the Ministry of Health Labour and Welfare of Japan, and Japan Society for the Promotion of Science (Tokyo, Japan). K. Hirooka received a funding from Novartis (Tokyo, Japan), Alcon (Tokyo, Japan), and Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (26462689).

C. Shiragami received financial support from Bayer (Osaka, Japan) and Novartis (Tokyo, Japan). A. Tsujikawa received financial support from Pfizer (Tokyo, Japan), Bayer (Osaka, Japan), Novartis (Tokyo, Japan), Santen (Osaka, Japan), Senju (Osaka, Japan), Alcon (Tokyo, Japan), Nidek (Gamagori, Japan), AMO Japan (Tokyo, Japan), Kowa (Nagoya, Japan), and Sanwa Kagaku (Nagoya, Japan). The remaining authors have no conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.