{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:45:11Z","timestamp":1791384311705,"version":"4.3.3"},"reference-count":38,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,4,24]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To assess choriocapillaris flow deficit percentage (CCFD%) across stages of dry age-related macular degeneration (AMD) using swept-source optical coherence tomography angiography (SS-OCTA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cross-sectional, observational study included 270 eyes (182 patients), classified as early (70 eyes), intermediate (121 eyes) and geographic atrophy (GA, 79 eyes).<\/jats:p>\n                  <jats:p>Participants underwent a complete examination including macular 6\u00d76\u2009mm SS-OCTA scans (PLEX Elite 9000). Scans were reviewed and analysed for subretinal drusenoid deposits (SDDs), retinal pigment epithelium (RPE) atrophy size, incomplete RPE and outer retinal atrophy (iRORA) and drusen volume (3\u2009mm). CCFD% was calculated after compensation and binarisation using Phansalkar\u2019s method (r=4\u201315 pixels) in various early treatment for diabetic retinopathy study sectors. Linear mixed-effects models adjusted for age evaluated associations with AMD stages and other imaging biomarkers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>CCFD% progressively increased with advancing dry AMD stages. Intermediate AMD eyes showed higher CCFD% than early AMD ones across all regions (p&lt;0.001). GA eyes exhibited significantly higher CCFD% compared with early (p&lt;0.001) and intermediate AMD eyes (p&lt;0.001).<\/jats:p>\n                  <jats:p>SDDs were significantly associated with higher CCFD% in early (p&lt;0.01) and intermediate AMD (p&lt;0.05) for almost all regions examined, but not in GA (p&gt;0.05). iRORA presence in iAMD and larger RPE atrophy in GA correlated with increased CCFD% (p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study provides a comprehensive reference database for CCFD% across the stages of dry AMD using SS-OCTA. CCFD% increased with AMD severity, iRORA, SDDs, particularly in early and intermediate stages, and RPE atrophy size. Our findings support CCFD% as a valuable biomarker for clinical and research applications, warranting longitudinal studies to validate its prognostic value.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjo-2024-326416","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T13:20:15Z","timestamp":1747142415000},"page":"1020-1027","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Choriocapillaris impairment in dry AMD: insights from swept-source OCT angiography and associations with structural biomarkers"],"prefix":"10.1136","volume":"109","author":[{"given":"Katherine","family":"Overbey","sequence":"first","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Romano","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Ding","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cade F","family":"Bennett","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Stettler","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-8561","authenticated-orcid":false,"given":"Itika","family":"Garg","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Ploumi","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippos","family":"Vingopoulos","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Yuan","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman","family":"Razavi","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Finn","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas","family":"La\u00edns","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimesh A","family":"Patel","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Kim","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wu","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Eliott","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deeba","family":"Husain","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrios","family":"Vavvas","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-3996","authenticated-orcid":false,"given":"Joan W","family":"Miller","sequence":"additional","affiliation":[{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-9738","authenticated-orcid":false,"given":"John B","family":"Miller","sequence":"additional","affiliation":[{"name":"Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"2025082002151093000_109.9.1020.1","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1016\/S2214-109X(13)70145-1","article-title":"Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis","volume":"2","author":"Wong","year":"2014","journal-title":"Lancet Glob Health"},{"key":"2025082002151093000_109.9.1020.2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2013.7671"},{"key":"2025082002151093000_109.9.1020.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2021.100997"},{"key":"2025082002151093000_109.9.1020.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.036"},{"key":"2025082002151093000_109.9.1020.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2022.05.021"},{"key":"2025082002151093000_109.9.1020.6","doi-asserted-by":"publisher","DOI":"10.1007\/s40123-023-00807-9"},{"key":"2025082002151093000_109.9.1020.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2017.11.003"},{"key":"2025082002151093000_109.9.1020.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2021.100951"},{"key":"2025082002151093000_109.9.1020.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.02.003"},{"key":"2025082002151093000_109.9.1020.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.08.045"},{"key":"2025082002151093000_109.9.1020.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2018.08.014"},{"key":"2025082002151093000_109.9.1020.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-019-04403-1"},{"key":"2025082002151093000_109.9.1020.13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1167\/iovs.65.8.21","article-title":"Progressive Choriocapillaris Changes on Optical Coherence Tomography Angiography Correlate With Stage Progression in AMD","volume":"65","author":"Romano","year":"2024","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082002151093000_109.9.1020.14","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2020-316893"},{"key":"2025082002151093000_109.9.1020.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2023.04.011"},{"key":"2025082002151093000_109.9.1020.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2024.06.005"},{"key":"2025082002151093000_109.9.1020.17","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.63.12.1","article-title":"Impact of Reticular Pseudodrusen on Choriocapillaris Flow Deficits and Choroidal Structure on Optical Coherence Tomography Angiography","volume":"63","author":"Wu","year":"2022","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082002151093000_109.9.1020.18","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.64.4.15","article-title":"Decreased Macular Choriocapillaris Perfusion in Eyes With Macular Reticular Pseudodrusen Imaged With Swept-Source OCT Angiography","volume":"64","author":"Li","year":"2023","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082002151093000_109.9.1020.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2018.05.005"},{"key":"2025082002151093000_109.9.1020.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.09.035"},{"key":"2025082002151093000_109.9.1020.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.09.028"},{"key":"2025082002151093000_109.9.1020.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.11.004"},{"key":"2025082002151093000_109.9.1020.23","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-10582"},{"key":"2025082002151093000_109.9.1020.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2023.03.012"},{"key":"2025082002151093000_109.9.1020.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.07.003"},{"key":"2025082002151093000_109.9.1020.26","doi-asserted-by":"crossref","unstructured":"Romano F , Ding X , Garcia M , et al . Assessing the Repeatability of Inner Choroid Flow Deficit Percentage in Intermediate AMD and Controls: A Comparative Study between Different Post-processing Approaches. Retina (Philadelphia, Pa) 2024;39661945. doi:10.1097\/IAE.0000000000004345","DOI":"10.1097\/IAE.0000000000004345"},{"key":"2025082002151093000_109.9.1020.27","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.65.6.26","article-title":"Calcified Drusen Prevent the Detection of Underlying Choriocapillaris Using Swept-Source Optical Coherence Tomography Angiography","volume":"65","author":"Cheng","year":"2024","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082002151093000_109.9.1020.28","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6476"},{"key":"2025082002151093000_109.9.1020.29","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2013.5799"},{"key":"2025082002151093000_109.9.1020.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2016.07.023"},{"key":"2025082002151093000_109.9.1020.31","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.17-22360"},{"key":"2025082002151093000_109.9.1020.32","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.19-27861"},{"key":"2025082002151093000_109.9.1020.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2018.12.025"},{"key":"2025082002151093000_109.9.1020.34","first-page":"2015","article-title":"Spare the rods, save the cones in aging and age-related maculopathy","volume":"41","author":"Curcio","year":"2000","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082002151093000_109.9.1020.35","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13-11923"},{"key":"2025082002151093000_109.9.1020.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.04.037"},{"key":"2025082002151093000_109.9.1020.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2019.01.024"},{"key":"2025082002151093000_109.9.1020.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.08.047"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2024-326416","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T09:16:14Z","timestamp":1755681374000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2024-326416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":38,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bjo-2024-326416"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2024-326416","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]}}}