The Foveal Microvasculature of Adult Offspring of Patients with Neovascular Age-Related Macular Degeneration.

AIM: To assess the foveal microvasculature in adult offspring of patients with neovascular age-related macular degeneration (nAMD) who exhibit no clinical or imaging signs of AMD, and to compare these parameters with those of healthy controls without a family history of AMD. METHODS: This cross-sectional study included 82 adult offspring of patients with nAMD and 85 age- and sex-matched controls. Optical coherence tomography angiography (OCTA) was used to evaluate vessel densities of the superficial and deep capillary plexuses (SCP and DCP), the foveal avascular zone (FAZ), outer retinal flow, and choriocapillaris (CCP) flow area. RESULTS: There were no significant differences in demographic or visual parameters between groups, nor in FAZ area, perimeter, or acircularity index. However, vessel densities in all SCP and DCP zones, as well as outer retinal and CCP flow areas, were significantly reduced in the nAMD offspring group (all p < 0.05). CONCLUSION: Subclinical microvascular alterations in SCP, DCP, and CCP were identified in clinically unaffected adult offspring of patients with nAMD. These findings suggest a potential heritable vascular component in early AMD pathogenesis and support the use of OCTA as a tool for risk stratification.