• subfoveal choroidal thickness (SFCT) and choroidal vessel density (VD, %) are reduced in fellow eyes of N-AMD with SRFi. • SFCT thinning and VD loss are independent SRFi risk factors. • OCTA-based choroidal metrics may serve as early N-AMD biomarkers. To evaluate choroidal vascular alterations in the contralateral eyes of patients with neovascular age-related macular degeneration (N-AMD) and subretinal fibrosis (SRFi) using optical coherence tomography angiography (OCTA). This retrospective study included 57 patients (57 eyes) with unilateral N-AMD and a normal fellow eye. Patients were classified by multimodal imaging into SRFi (24 eyes) and non-SRFi (32 eyes) groups. Best-corrected visual acuity (BCVA, logMAR), subfoveal choroidal thickness (SFCT), and OCTA-derived choriocapillaris and choroidal vessel density (VD, %) were measured. Group differences were assessed using binarized OCTA scans, and correlation and logistic regression analyses were performed. SFCT was significantly reduced in the SRFi group compared with controls (P<0.05) and was positively correlated with choroidal VD (r=0.414, P=0.045). Multivariate logistic regression identified SFCT (OR=0.98, 95% CI: 0.96–0.99, P=0.006) and choroidal VD (OR=0.85, 95% CI: 0.72–1.00, P=0.047) as independent risk factors for SRFi. Decreased SFCT and choroidal VD in the contralateral eyes of N-AMD patients with SRFi suggest a potential role in disease pathogenesis and progression. These parameters may serve as early biomarkers for the onset of SRFi in N-AMD.
Du et al. (Sun,) studied this question.