Macular atrophy and choriocapillaris nonperfusion
Reviewed by Saruban Pasu

This Japanese study compared the choriocapillaris (CC) nonperfusion area as measured on OCTA with areas of macular atrophy (MA) measured by fundus autofluoresence (FAF). A total of 44 eyes were assessed (31 were treated with anti-VEGF alone and 13 had combined (photodynamic therapy – (PDT)). Most CC nonperfusion areas measured on OCTA were larger than the MA area measured on FAF. The area of CC nonperfusion in all cases included more than 50% of the MA area. The MA area was completely encompassed by the CC nonperfusion area in 11 eyes (25.0%). The CC nonperfusion area was larger than the MA area in 39 eyes (88.6%), and there was a linear relationship between the two variables. Choriocapillaris nonperfusion areas were significantly larger in eyes treated with combined PDT than in eyes treated with anti-VEGF therapy alone (P<0.05). Macular atrophy areas were significantly larger in eyes treated with combined PDT than in eyes treated with anti-VEGF therapy alone (P<0.05). No significant correlation was observed between the total number of anti-VEGF injections and CC nonperfusion area. These results suggest that CC nonperfusion occurs simultaneously, or earlier than MA development.

Macular atrophy findings by optical coherence tomography angiography compared with fundus autofluorescence in treated exudative age-related macular degeneration.
Takasago Y, Shiragami C, Kobayashi M, et al.
RETINA
2019;39(2):296-302.