School of Medicine and Health Sciences Poster Presentations

Title

The Cilioretinal Artery is Protective Against Choroidal Neovascularization in Age-Related Macular Degeneration

Poster Number

198

Document Type

Poster

Status

Medical Student

Abstract Category

Clinical Specialties

Keywords

Retina, Age-Related Macular Degeneration, Cilioretinal Artery, Choroidal Neovascularization

Publication Date

Spring 2018

Abstract

Importance: A hemodynamic role in the pathogenesis of age-related macular degeneration (AMD) has been proposed, but a relationship between retinal vasculature and late AMD has not been investigated. Objective: To determine if the presence and location of a cilioretinal artery may affect the risk of developing late AMD in the age-related eye disease study (AREDS). Design, Setting, and Participants: Retrospective analysis of prospective, randomized, clinical trial data from 3647 AREDS participants. Fundus photographs of AREDS participants were reviewed by two masked graders for the presence or absence of a cilioretinal artery, and if any branch extend within 500µm of the center of the macula. Multivariate regressions were used to determine the association of the cilioretinal artery and vessel location, adjusted for age, sex, and smoking status, with the prevalence of choroidal neovascularization (CNV) or central geographic atrophy (CGA), as well as AMD severity score, for eyes at randomization and progression at 5 years. Main Outcomes and Measures: Association of cilioretinal artery with prevalence of and progression to CNV or CGA. Results: Among AREDS participants, 26.9% of subjects had a cilioretinal artery in one eye, and 8.4% had the vessel bilaterally. At randomization, eyes with a cilioretinal artery had a lower prevalence of CNV (5.0% vs. 7.6%, OR 0.66, P=0.001), but no difference in CGA (1.1% vs 0.8%, OR 1.33, P=0.310). In eyes without late AMD, those with a cilioretinal artery also had a lower AMD severity score (3.00 ± 2.35 vs. 3.19 ± 2.40, P=0.019). At 5 years, eyes at risk with a cilioretinal artery had lower rates of progression to CNV (4.1% vs 5.5%, OR 0.75, P=0.050), but no difference in developing CGA (2.2% vs. 2.7%, OR 0.83, P=0.354) or change in AMD severity score (+0.65 ± 1.55 vs. +0.73 ± 1.70, P=0.112). In subjects with a unilateral cilioretinal artery, eyes with the vessel showed a lower prevalence of CNV than the fellow eyes (4.7% vs. 7.2%, P=0.012). Conclusions and Relevance: The presence of a cilioretinal artery may be protective against the development of CNV, but not CGA. This finding suggests a hemodynamic contribution to neovascular AMD pathogenesis.

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The Cilioretinal Artery is Protective Against Choroidal Neovascularization in Age-Related Macular Degeneration

Importance: A hemodynamic role in the pathogenesis of age-related macular degeneration (AMD) has been proposed, but a relationship between retinal vasculature and late AMD has not been investigated. Objective: To determine if the presence and location of a cilioretinal artery may affect the risk of developing late AMD in the age-related eye disease study (AREDS). Design, Setting, and Participants: Retrospective analysis of prospective, randomized, clinical trial data from 3647 AREDS participants. Fundus photographs of AREDS participants were reviewed by two masked graders for the presence or absence of a cilioretinal artery, and if any branch extend within 500µm of the center of the macula. Multivariate regressions were used to determine the association of the cilioretinal artery and vessel location, adjusted for age, sex, and smoking status, with the prevalence of choroidal neovascularization (CNV) or central geographic atrophy (CGA), as well as AMD severity score, for eyes at randomization and progression at 5 years. Main Outcomes and Measures: Association of cilioretinal artery with prevalence of and progression to CNV or CGA. Results: Among AREDS participants, 26.9% of subjects had a cilioretinal artery in one eye, and 8.4% had the vessel bilaterally. At randomization, eyes with a cilioretinal artery had a lower prevalence of CNV (5.0% vs. 7.6%, OR 0.66, P=0.001), but no difference in CGA (1.1% vs 0.8%, OR 1.33, P=0.310). In eyes without late AMD, those with a cilioretinal artery also had a lower AMD severity score (3.00 ± 2.35 vs. 3.19 ± 2.40, P=0.019). At 5 years, eyes at risk with a cilioretinal artery had lower rates of progression to CNV (4.1% vs 5.5%, OR 0.75, P=0.050), but no difference in developing CGA (2.2% vs. 2.7%, OR 0.83, P=0.354) or change in AMD severity score (+0.65 ± 1.55 vs. +0.73 ± 1.70, P=0.112). In subjects with a unilateral cilioretinal artery, eyes with the vessel showed a lower prevalence of CNV than the fellow eyes (4.7% vs. 7.2%, P=0.012). Conclusions and Relevance: The presence of a cilioretinal artery may be protective against the development of CNV, but not CGA. This finding suggests a hemodynamic contribution to neovascular AMD pathogenesis.