TY - JOUR
T1 - Visual Acuity and Foveal Structure in Eyes with Fragmented Foveal Avascular Zones
AU - Linderman, Rachel E.
AU - Cava, Jenna A.
AU - Salmon, Alexander E.
AU - Chui, Toco Y.
AU - Marmorstein, Alan D.
AU - Lujan, Brandon J.
AU - Rosen, Richard B.
AU - Carroll, Joseph
N1 - Funding Information:
Supported in part by the National Eye Institute, National Institutes of Health, Bethesda, Maryland (grant nos.: R01EY024969, P30EY001931, R01EY027301, T32EY014537, R01EY017607, and P30EY010572); the National Center for Advancing Translational Sciences, National Institutes of Health (grant no.: UL1TR001436); and the National Institute of Aging, National Institutes of Health (grant no.: T35AG029793). This investigation was conducted in a facility constructed with support from the Research Facilities Improvement Program, National Center for Research Resources, National Institutes of Health (grant no.: C06RR016511). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional support was received from Research to Prevent Blindness, Inc, New York, New York (unrestricted departmental award); and the Nick Cacciola Summer Student Fellowship Award from Fight for Sight (R.E.L.), New York, New York. Financial Disclosure(s): The author(s) have made the following disclosure(s): R.E.L.: Consultant - OptoVue. B.J.L.: Consultant - Genentech/Roche, CellCure, BioTime, Lineage Cell Therapeutics, Novartis; Financial support - Carl Zeiss Meditec, OptoVue; Equity owner - Translational Imaging Innovations, Inc; Patent - Directional optical coherence tomography (University of California, Berkeley). R.B.R.: Consultant - Optovue, Astellas, NanoRetina, OD-OS, Regeneron, Boehringer- Ingelheim, Advanced Cellular Technologies, Clarity; Financial support - Carl Zeiss Meditec, Zeavision; Equity owner - Opticology, Guardion Health. J.C.: Consultant - MeiraGTx; Equity owner - Translational Imaging Innovations, Inc; Nonfinancial support - OptoVue. Obtained funding: Carroll
Publisher Copyright:
© 2019 American Academy of Ophthalmology
PY - 2020/5
Y1 - 2020/5
N2 - Purpose: To assess the frequency and impact of abnormal foveal avascular zone (FAZ) topography (i.e., a fragmented FAZ) on visual acuity and foveal anatomic features. Design: Prospective, cross-sectional study from March 2018 through July 2019. Participants: Two-hundred fifty participants were screened from a normative OCT angiography database. Of those, 12 participants were found to have at least 1 eye with a fragmented FAZ. Eight returned for follow-up imaging, along with an additional 3 participants with ocular disease (amblyopia, autosomal recessive bestrophinopathy, premature birth) having a similar FAZ phenotype. Methods: Follow-up OCT imaging and monocular best-corrected visual acuity (BCVA) were performed for these 11 participants. Twenty-four participants with a clearly defined FAZ were recruited for comparison. A normative database was created measuring parafoveal intercapillary area (PICA) to determine if an FAZ was fragmented. Main Outcome Measures: Monocular BCVA, foveal pit depth, foveal pit area, PICA, outer nuclear layer thickness, foveal inner retinal area, and peak cone density. Results: The frequency of a fragmented FAZ was 4.8% of individuals (12 of 250) or 3.6% of eyes (18 of 500 eyes). A significant difference was found between the control eyes and eyes with fragmented FAZs for foveal pit depth, pit area, and total PICA (P < 0.001, P = 0.002, and P < 0.001, respectively). The presence of a fragmented FAZ did not affect visual acuity. Conclusions: The presence of a fragmented FAZ seems not to be a rare phenotype in individuals with normal vision. The presence of altered FAZ topography in patients with retinal or systemic disease could negatively impact the accuracy and sensitivity of biomarkers dependent on FAZ identification.
AB - Purpose: To assess the frequency and impact of abnormal foveal avascular zone (FAZ) topography (i.e., a fragmented FAZ) on visual acuity and foveal anatomic features. Design: Prospective, cross-sectional study from March 2018 through July 2019. Participants: Two-hundred fifty participants were screened from a normative OCT angiography database. Of those, 12 participants were found to have at least 1 eye with a fragmented FAZ. Eight returned for follow-up imaging, along with an additional 3 participants with ocular disease (amblyopia, autosomal recessive bestrophinopathy, premature birth) having a similar FAZ phenotype. Methods: Follow-up OCT imaging and monocular best-corrected visual acuity (BCVA) were performed for these 11 participants. Twenty-four participants with a clearly defined FAZ were recruited for comparison. A normative database was created measuring parafoveal intercapillary area (PICA) to determine if an FAZ was fragmented. Main Outcome Measures: Monocular BCVA, foveal pit depth, foveal pit area, PICA, outer nuclear layer thickness, foveal inner retinal area, and peak cone density. Results: The frequency of a fragmented FAZ was 4.8% of individuals (12 of 250) or 3.6% of eyes (18 of 500 eyes). A significant difference was found between the control eyes and eyes with fragmented FAZs for foveal pit depth, pit area, and total PICA (P < 0.001, P = 0.002, and P < 0.001, respectively). The presence of a fragmented FAZ did not affect visual acuity. Conclusions: The presence of a fragmented FAZ seems not to be a rare phenotype in individuals with normal vision. The presence of altered FAZ topography in patients with retinal or systemic disease could negatively impact the accuracy and sensitivity of biomarkers dependent on FAZ identification.
UR - http://www.scopus.com/inward/record.url?scp=85078051790&partnerID=8YFLogxK
U2 - 10.1016/j.oret.2019.11.014
DO - 10.1016/j.oret.2019.11.014
M3 - Article
C2 - 31956075
AN - SCOPUS:85078051790
SN - 2468-6530
VL - 4
SP - 535
EP - 544
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 5
ER -