Studying Eye Blood Flow During Exercise to Understand the Origins of AMD

This project applies motion-tolerant robotic OCT angiography during exercise to search for hypothesized choriocapillaris vascular anomalies not seen at rest that later progress to reticular pseudodrusen, thereby elucidating the potential vascular origins of AMD.

This proposal uses blood vessel mapping during exercise to understand how blood flow in the eye is involved in the development of age-related macular degeneration (AMD). Much like how an exercise stress test reveals disease in vessels in the heart, we propose an ocular stress test to allow us to detect disease affecting the eye before vision loss develops. In this proposal, we first compare patients with and without AMD to evaluate how their blood vessels behave differently during exercise and then follow patients over time to understand how their blood vessels change as disease evolves.

The most innovative component of this proposal is our experiment to measure eye blood flow at rest and during dynamic exercise in healthy adults and AMD patients. We call this experiment an “ocular stress test,” analogous to how an exercise stress test reveals coronary vascular abnormalities not otherwise seen at rest. The experiment relies upon our unique motion-tolerant robotic eye imaging capabilities.

This project will test the hypothesized relationship between choriocapillaris flow voids and reticular pseudodrusen (RPD) in AMD. Supporting or refuting this relationship will direct future studies to undercover the pathophysiology in RPD-driven AMD. This may support specific therapeutic interventions for this subset of AMD patients that focus on hypoxia and choriocapillaris flow, including radical therapies like ophthalmic artery angioplasty.