Unilateral Cilioretinal Artery and Advanced Age-Related Macular Degeneration: A Retrospective Cross-Sectional Study

Purpose To investigate the association between the presence of a cilioretinal artery (CRA) and advanced age-related macular degeneration (AMD), including the prevalence of choroidal neovascularization (CNV) and geographic atrophy (GA). Design Retrospective cross-sectional study. Methods Setting: Single center Patient population: A total of 738 patients with AMD who underwent optical coherence tomography angiography (OCTA) were included in the study. Fundus photographs were reviewed to determine the presence of the CRA. Intervention/observation procedures: In patients with a unilateral CRA, paired tests were performed between eyes with and without the CRA to compare AMD severity and prevalence of CNV and GA. Main outcomes: AMD stage, and prevalence of CNV and GA. Macular vasculature, including vessel density, perfusion density, and foveal avascular zone, examined using OCTA. Results A total of 27.8% and 8.1% of patients had a CRA in one and both eyes, respectively. A total of 174 eyes from 87 patients with a unilateral CRA were examined. Eyes with a CRA showed lower AMD stage (4-step AREDS category; P = 0.037) and a lower prevalence of CNV (23.0% vs. 41.4%; P = 0.024) than those without a CRA. The prevalence of GA and macular vessel density, perfusion density, and foveal avascular zone measured by OCTA were similar in both groups. Conclusions In the eyes with a CRA, AMD stage and prevalence of CNV were lower than those in the eyes without a CRA. However, the effect of the CRA on the macular vascular system remains unclear.