Choriocapillaris Nonperfusion is Associated With Poor Visual Acuity in Eyes With Reticular Pseudodrusen

Peter L. Nesper, Brian T. Soetikno, Amani A. Fawzi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

95 Scopus citations


Purpose To study choriocapillaris blood flow in age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA) and study its correlation to visual acuity (VA) in eyes with reticular pseudodrusen (RPD) vs those with drusen without RPD (drusen). Design Cross-sectional study. Methods Patients with either drusen or RPD in early AMD underwent OCTA imaging of the superior, inferior, and/or nasal macula. We quantified “percent choriocapillaris area of nonperfusion” (PCAN) in eyes with RPD vs those with drusen. We assessed the repeatability of PCAN and its correlations with VA. Results Twenty-nine eyes of 26 patients with RPD and 21 eyes of 16 age-matched AMD patients with drusen were included. Qualitatively, the choriocapillaris in areas with RPD showed focal dark regions without flow signal on OCTA (nonperfusion). The repeatability coefficient of PCAN was 0.49%. Eyes with RPD had significantly greater PCAN compared with eyes with drusen (7.31% and 3.88%, respectively; P <.001). We found a significant correlation between PCAN and VA for the entire dataset (r = 0.394, P =.005). When considering eyes with RPD separately, this correlation was stronger (r = 0.474, P =.009) but lost significance when considering eyes with drusen separately (r = 0.175, P =.45). Conclusions Eyes with RPD have significantly larger areas of choriocapillaris nonperfusion compared with eyes with drusen and no RPD. The correlation between PCAN and VA in this RPD population provides a potential mechanistic explanation for vision compromise in RPD compared with other forms of drusen in AMD.

Original languageEnglish (US)
Pages (from-to)42-55
Number of pages14
JournalAmerican journal of ophthalmology
StatePublished - Feb 1 2017

ASJC Scopus subject areas

  • Ophthalmology


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