A comparative study of choroidal structural features in eyes with central macular atrophy related to Stargardt disease and non-exudative age-related macular degeneration.

Purpose: To compare choroidal structural features in eyes with central macular atrophy related to Stargardt disease (STGD) and non-exudative age-related macular degeneration (AMD).

Methods: Twenty-five eyes of 25 Stargardt cases and 25 eyes of 25 non-exudative AMD cases were included in this retrospective study. Region Finder software was used to measure atrophic areas on blue-light fundus autofluorescence images centered on the macula. The total choroidal area (TCA), luminal area (LA), and stromal area (SA) were calculated using the ImageJ program and Niblack autolocal thresholding method. The choroidal vascularity index (CVI) was assessed.

Results: The mean age was 59.4 ± 10.9 years in the STGD group and 68.1 ± 7.6 years in the non-exudative AMD group (P = 0.002). The mean macular atrophic area was 16.06 ± 10.61 mm2 in STGD and 11.73 ± 7.65 mm2 in non-exudative AMD (P = 0.171). The STGD group had significantly higher mean subfoveal choroidal thickness (184.0 ± 62.6 vs. 131.8 ± 62.4 µm), TCA (0.553 ± 0.201 vs. 0.406 ± 0.189 mm2), LA (0.344 ± 0.150 vs. 0.253 ± 0.124 mm2), and SA values (0.208 ± 0.062 vs. 0.153 ± 0.069 mm2) compared to the non-exudative AMD group (P = 0.004, P = 0.011, P = 0.023, and P = 0.004, respectively). However, CVI values did not differ significantly between the two groups (60.58 ± 7.4 vs. 61.93 ± 5.8%, P = 0.432). According to the results of the ANCOVA test, differences in mean SFCT, TCA, and SA persisted when the data were readjusted for age (P = 0.018, P = 0.035, and P = 0.017, respectively).

Conclusion: In non-exudative AMD with geographic atrophy, the reductions in the choroidal compartments are more pronounced than those in STGD. However, similar CVI values may suggest that controversy still exists regarding the role of choroidal compartmental changes in the development of atrophy.