Choroidal thickness, vascular hyperpermeability, and complement factor H in age-related macular degeneration and polypoidal choroidal vasculopathy

Invest Ophthalmol Vis Sci. 2012 Jun 14;53(7):3663-72. doi: 10.1167/iovs.12-9619.

Abstract

Purpose: To investigate the relationship between subfoveal choroidal thickness, choroidal vascular hyperpermeability, and complement factor H (CFH) gene polymorphism in typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).

Methods: Fifty-eight patients with typical AMD and 63 patients with PCV underwent fluorescein angiography, indocyanine green angiography (IA), and spectral-domain optical coherence tomography (OCT) using enhanced depth imaging (EDI). Subfoveal choroidal thickness was measured using EDI-OCT images, and choroidal hyperpermeability was evaluated using late-phase IA images. The major AMD-associated single-nucleotide polymorphisms were genotyped in 86 patients.

Results: Mean subfoveal choroidal thickness was significantly lower in eyes with typical AMD than that in eyes with PCV (P = 0.025). Subfoveal choroidal thickness was greater in eyes with choroidal hyperpermeability than that in eyes without it in typical AMD (P < 0.001) and PCV (P = 0.020), and in the fellow eyes of typical AMD (P < 0.001) and PCV (P = 0.027). In eyes without choroidal hyperpermeability, the mean subfoveal choroidal thickness was greater in PCV than that in typical AMD (P = 0.001). Choroidal thickness decreased after photodynamic therapy combined with intravitreal ranibizumab in typical AMD (P = 0.016) and PCV (P = 0.036). In eyes with PCV, the I62V polymorphism in the CFH gene contributed to choroidal thickness (P = 0.043).

Conclusions: Choroidal thickness is related to the AMD subtypes, choroidal hyperpermeability, and I62V CFH gene polymorphism. In eyes without choroidal hyperpermeability, EDI-OCT is useful as an auxiliary measure for differentiating typical AMD and PCV.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Capillary Permeability / physiology*
  • Choroid / blood supply
  • Choroid / metabolism*
  • Choroid / pathology
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / genetics
  • Choroidal Neovascularization / pathology*
  • Complement Factor H / genetics*
  • Complement Factor H / metabolism
  • DNA / genetics*
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Hypertrophy
  • Intravitreal Injections
  • Macular Degeneration / drug therapy
  • Macular Degeneration / genetics
  • Macular Degeneration / pathology*
  • Male
  • Ophthalmoscopy
  • Photochemotherapy
  • Polymorphism, Single Nucleotide*
  • Prognosis
  • Ranibizumab
  • Tomography, Optical Coherence
  • Visual Acuity

Substances

  • Antibodies, Monoclonal, Humanized
  • Complement Factor H
  • DNA
  • Ranibizumab