CHOROIDAL THICKNESS, VASCULAR FACTORS, AND AGE-RELATED MACULAR DEGENERATION The ALIENOR Study

Purpose: To study the associations of subfoveal choroidal thickness with vascular risk factors and age-related macular degeneration. Methods: Two hundred sixty-one participants of the Alienor study had gradable enhanced-depth imaging optical coherence tomography scans of the macula and available data on vascular and genetic risk factors (assessed through face-to-face interview and fasting blood samples) and age-related macular degeneration status (assessed from retinal photographs and optical coherence tomography). Subfoveal choroidal thickness was measured manually on one horizontal scan passing through the fovea. Results: In a multivariate mixed linear model, subfoveal choroidal thickness was independently associated with age greater than 80 years (-21.77 mu m, P = 0.02), axial length (-21.77 mu m, P < 0.0001), heavy smoking (>= 20 pack-years: 224.89 mm, P = 0.05), fasting blood glucose higher than 7 mmol/L (-53.17 mu m, P = 0.02), and lipid-lowering treatment (+18.23, P = 0.047). After multivariate adjustment for age, sex, axial length, and vascular and genetic risk factors, subfoveal choroidal thickness was thinner in eyes with central hyperpigmentation (-45.39 mu m, P = 0.006), central hypopigmentation (-44.99 mu m, P = 0.001), and central pigmentary abnormalities (-44.50 mu m, P = 0.001), but not in eyes with late agerelated macular degeneration (-18.05 mu m, P = 0.33) or soft drusen. Conclusion: These findings indicate a relationship between vascular risk factors and choroidal thinning and suggest an early involvement of the choroid in the pathogenesis of age-related macular degeneration.