Age-related choroidal atrophy

Abstract

Purpose: To report the clinical characteristics of a newly defined entity, age-related choroidal atrophy.

Design: Retrospective, observational case series.

Methods: The choroidal thickness was measured in images obtained by positioning a spectral-domain optical coherence tomography device close enough to the eye to acquire an inverted image. Seven sections each comprised of 100 averaged scans were obtained within a 5 x 15-degree or larger rectangle to encompass the macula and temporal juxtapapillary retina. The choroidal thickness of patients less than 125 microm in thickness were included, whereas eyes with myopia of 6 diopters or more, a history of uveitis, trauma, ionizing radiation, photodynamic therapy, intravitreal corticosteroid injection, or tapetoretinal dystrophy were excluded. The patients were evaluated for visual acuity, macular appearance, and the presence of glaucoma.

Results: There were 28 eligible eyes of 17 patients with a mean age 80.6 years (standard deviation, +/- 7.3 years). All eyes had a tessellated fundus appearance. The mean subfoveal choroidal thickness was 69.8 microm and became even more attenuated nasally. Of the 18 eyes that had no evidence of late age-related macular degeneration (AMD), the mean visual acuity was 20/40, there were pigmentary changes in the macula that arose in part from the choroid potentially mimicking early AMD, and a rarefaction of the choroidal vessels under the macula. Concurrent late AMD was found in the 10 remaining eyes. Glaucoma was present in 6 patients (35.3%), all of whom had peripapillary atrophy. The choroid was seen to become nearly obliterated before the demarcation of the beta-zone of peripapillary atrophy.

Conclusions: Age-related choroidal atrophy affects older individuals in whom posterior pole abnormalities develop that may mimic and also be associated with findings typical for AMD. Patients with age-related choroidal atrophy may be at higher risk for glaucoma.