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

IF 5 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2026-02-01 Epub Date: 2025-10-27 DOI:10.1016/j.xops.2025.100986

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

{"title":"Association between Baseline Subfoveal Choroidal Thickness and Anatomical and Functional Outcomes in Geographic Atrophy","authors":"Alythia Vo BS , Liangbo Linus Shen MD , Irene Pak BS , Abu Tahir Taha BS , Antonio Z. Diaz BS , Jay M. Stewart MD","doi":"10.1016/j.xops.2025.100986","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design</h3><div>Secondary analysis of a randomized controlled trial.</div></div><div><h3>Participants</h3><div>Seventy 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.</div></div><div><h3>Methods</h3><div>Subfoveal choroidal thickness was measured from baseline OCT. 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. Geographic atrophy perimeter-adjusted growth rate was calculated by dividing GA area growth rate by the mean GA perimeter between the first and last visit.</div></div><div><h3>Main Outcome Measures</h3><div>Longitudinal changes in GA area and visual acuity.</div></div><div><h3>Results</h3><div>Baseline SFChT was not significantly associated with baseline GA area (<em>P</em> = 0.51), baseline best-corrected visual acuity (BCVA) (<em>P</em> = 0.49), baseline low-luminance visual acuity (LLVA) (<em>P</em> = 0.85), or rim area focal hyperautofluorescence signals (<em>P</em> = 0.29). Baseline SFChT was not significantly associated with GA perimeter-adjusted growth rate (<em>P</em> = 0.74), the decline rate of BCVA (<em>P</em> = 0.14), and the decline rate of LLVA (<em>P</em> = 0.71). However, sensitivity analyses in GA subgroups found that baseline SFChT was associated with decreased rate of BCVA decline in patients with foveal-involving GA (Spearman ρ = 0.03, <em>P</em> = 0.03). Baseline SFChT did not significantly influence the effect of oral metformin on GA perimeter-adjusted growth rate (<em>P</em> = 0.78).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"6 2","pages":"Article 100986"},"PeriodicalIF":5.0000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525002842","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

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 trial.

Participants

Seventy 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

Subfoveal choroidal thickness was measured from baseline OCT. 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. Geographic atrophy perimeter-adjusted growth rate was calculated by dividing GA area growth rate by the mean GA perimeter between the first and last visit.

Main Outcome 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 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-involving GA (Spearman 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).

Conclusions

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.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

基线中央凹下脉络膜厚度与地理萎缩的解剖和功能结果的关系

目的探讨基线中央凹下脉络膜厚度（SFChT）与视力和地理萎缩（GA）生长速率的关系，并评价SFChT是否介导口服二甲双胍对GA进展的治疗效果。设计随机对照试验的二次分析。参与者：来自44名GA患者（21名二甲双胍，23名观察）的70只眼睛（34只二甲双胍，36只观察），在二甲双胍最小化地理萎缩进展研究中随访≥6个月。方法以基线oct为基准点测量中央凹下脉络膜厚度，用首次访视时的脉络膜面积减去最后一次访视时的脉络膜面积，除以时间间隔，计算出脉络膜面积的生长率。地理萎缩周长调整的生长率是用GA面积增长率除以第一次和最后一次访问之间的平均GA周长。主要观察指标：GA区和视力的纵向变化。结果基线SFChT与基线GA面积（P = 0.51）、基线最佳矫正视力（BCVA）（P = 0.49）、基线低亮度视力（LLVA）（P = 0.85）或边缘区域焦点高自体荧光信号（P = 0.29）无显著相关性。基线SFChT与GA周界调整生长率（P = 0.74）、BCVA下降率（P = 0.14）和LLVA下降率（P = 0.71）无显著相关性。然而，GA亚组的敏感性分析发现，基线SFChT与累及中央窝的GA患者BCVA下降率降低相关（Spearman ρ = 0.03, P = 0.03）。基线SFChT对口服二甲双胍对GA周长调整生长率的影响不显著（P = 0.78）。结论较高的SFChT基线值与累及中央凹的GA患者BCVA下降较慢显著相关，提示脉络膜厚度可能在保护中心视力方面起局部作用。然而，SFChT与GA生长速率、LLVA下降或基线解剖和功能测量无关。它也没有介导口服二甲双胍的作用。虽然SFChT总体上缺乏对GA进展的预后价值，但它与累及中央凹的GA的中枢视力结果的相关性可能有限。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊