Abstract

CHOROIDAL THICKNESS IN AGE RELATED MACULAR DEGENERATION (AMD)

*Dr. Najeeb Ullah Khan, Dr. Arifa, Dr. Faisal, Dr. Alyscia M. Cheema, Dr. Aziz Ur Rehman and Dr. Ali Tahir

Abstract

Objective: To determine the relationship between Central Sub- Macular thickness of choroid and different clinical presentations in old age patients with disease known as age related macular degeneration (AMD) using swept-source optical coherence tomography (SS-OCT). Study Design: Prospective Cross-sectional analysis. Place and Duration of Study: Ward 11 Retina clinic, Ophthalmology department of JPMC Karachi from April 2021 to August 2021. Methods: Total of 51 patients with sixty three eyes with dry and wet AMD were observed after approval of article from Research and ethical committee of Jinnah post graduate medical Center (JPMC). Central sub-macular choroidal thickness was measured by two observers, 7 different sub-macular section sites were selected for measurement of choroidal thickness from quality picture of horizontal 1-line raster scan. A questionnaire chart data was collected from patient before the OCT Scan about visual acuity, duration of disease, history of cataract surgery, total number of anti-vascular endothelial growth factor (VEGF) intravitreal injections. The average thickness and Standard deviation of sub-macular thickness of choroid changes in dry and wet AMD was determined by Microsoft excel. Results: A wide variation was observed in sub-macular thickness of choroid in dry and wet AMD of patients above and below the normal means (range 137 to 398μm) with standard deviation (SD= 58). Nearly 14% of eyes with AMD measured less than1 standard deviation below the mean, 8% of eyes are above 1 SD. The mean thickness of choroid in wet AMD was 226.8, SD = 73.7 (n =18) and the mean thickness of choroid in dry AMD was 210.2(SD, 50.9; n = 45) No significant correlation was found between sub-macular thickness of choroid with visual acuity, disease duration, and total number of anti –VEGF intravitreal injections. Conclusion: This study described that sub-macular choroidal thickness can be easily measured using Swept-source optical coherence tomography and there is variation between choroidal thickness of wet AMD and dry AMD. However it is unclear that duration and severity of disease and intravitreal anti-VEGF injection has any effect on sub-macular choroidal thickness. Further detailed studies should be conducted to understand the significance of choroidal thickness with respect to visual acuity and severity of disease and the impact of intravitreal anti-VEGF on choroidal thickness.

Keywords: Age related Macular degeneration (AMD), Thickness of Choroid, Swept-source Optical coherence tomography (OCT).