Work

Association between Baseline Subfoveal Choroidal Thickness and Anatomical and Functional Outcomes in Geographic Atrophy

Year: 2025

Type: article

Abstract: Objective: To investigate the relationship between baseline subfoveal choroidal thickness (SFChT) and both visual outcomes and geographic atrophy (GA) growth rate, and to assess whether SFChT mediates the treatment effect of oral metformin on GA progression. Design: Secondary analysis of a randomized controlled trialParticipants: 70 eyes (34 metformin; 36 observation) from 44 participants (21 metformin; 23 observation) with GA and ≥6 months of follow-up in the METformin for the MINimization of Geographic Atrophy progression study.Methods: SFChT was measured from baseline optical coherence tomography.We calculated GA area growth rate by subtracting the GA area at the first visit from the GA area at the last visit and dividing the result by the time interval.GA perimeter-adjusted growth rate was calculated by dividing GA area growth rate by the mean GA perimeter between the first and last visit. MainOutcome Measures: Longitudinal changes in GA area and visual acuity Results: Baseline SFChT was not significantly associated with baseline GA area (P = 0.51), baseline best-corrected visual acuity (BCVA) (P = 0.49), baseline low-luminance visual acuity (LLVA) (P = 0.85), or rim area focal hyperautofluorescence (RAFH) signals (P = 0.29).Baseline SFChT was not significantly associated with GA perimeter-adjusted growth rate (P = 0.74), the decline rate of BCVA (P = 0.14), and the decline rate of LLVA (P = 0.71).However, sensitivity analyses in GA subgroups found that baseline SFChT was associated with decreased rate of BCVA decline in patients with foveal-J o u r n a l P r e -p r o o f involving GA (Spearman's ρ = 0.03, P = 0.03).Baseline SFChT did not significantly influence the effect of oral metformin on GA perimeter-adjusted growth rate (P = 0.78).Conclusion: Greater baseline SFChT was significantly associated with slower BCVA decline in eyes with foveal involving GA, suggesting a possible localized role of choroidal thickness in preserving central vision.However, SFChT was not associated with GA growth rate, LLVA decline, or baseline anatomical and functional measures.It also did not mediate the effect of oral metformin.While SFChT lacks prognostic value for GA progression overall, it may hold limited relevance for central vision outcomes in foveal-involving GA.J o u r n a l P r e -p r o o f Précis Greater baseline subfoveal choroidal thickness was associated with slower bestcorrected visual acuity decline in foveal-involving geographic atrophy, suggesting localized vision preservation.However, it showed no association with atrophy expansion or low luminance visual acuity decline.J o u r n a l P r e -p r o o f

Source: Ophthalmology Science

DOI: 10.1016/j.xops.2025.100986

Authors: Alythia Vo, Liangbo Linus Shen, Irene Pak, Abu Tahir Taha, Antonio Z. Diaz, Jay M. Stewart

Institutions: San Francisco General Hospital, University of California, San Francisco, Duke University, Duke Medical Center

Language: English

Topic: Retinal Diseases and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500