Plexus-specific retinal capillary avascular area in exudative age-related macular degeneration with projection-resolved OCT angiography

Objective To detect the plexus-specific retinal capillary avascular area in exudative age-related macular degeneration (EAMD) with projection-resolved optical coherence tomography angiography (PR-OCTA). Methods and analysis In this prospective cross-sectional single centre study, eyes with treatment-naive EAMD underwent macular 3x3 mm OCTA with AngioVue system. OCTA scans were analysed and processed including three-dimensional projection artefact removal, retinal layer semi-automated segmentation and en face angiogram generation. Automated quantification of extrafoveal (excluding the central 1 mm circle) avascular area (EAA) were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), respectively. Results Nineteen eyes with EAMD and 19 age-matched healthy control eyes were included. There was no significant difference between the EAMD and control eyes in terms of age, sex, axial length and mean ocular perfusion pressure (all p>0.05). Compared with control eyes, EAMD eyes had significantly larger EAA in SVC (median 0.125 vs 0.059 mm(2), p=0.006), ICP (0.016 vs 0.000 mm(2), p=0.004) and DCP (0.033 vs 0.000 mm2, p<0.001). Conclusion PR-OCTA showed that EAMD is associated with focal avascular area in all the three retinal vascular plexuses.