AIM: To investigate variations in macular blood flow density and morphological structural in early age-related macular degeneration(ARMD)by using optical coherence tomography angiography(OCTA).

METHODS: The retrospective review included 35 patients(35 eyes)which were first diagnosed with wet age-related macular degeneration(wARMD)in one eye and the fellow eye with early ARMD in our hospital at February 2018. A total of 35(35 subjects)healthy eyes with matched age were enrolled in the control group. All the patients with early ARMD eyes were imaged by OCTA at two points: baseline and 2y later. To obeserve the change of the range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer, foveal avascular zone area, perimeter and acircularity index, and the macular thickness of the full layer, inner layer, outer layer retina and ISOS-BRM.

RESULTS: The range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer in early ARMD patients were lower in early ARMD eyes than controls(P<0.05), and the macular thickness of the full layer and inner layer were reduced(P<0.05), while the thickness of ISOS-BRM increased(P=0.37). There was no significant change in the area of macular foveal, perimeter and acircularity index(P>0.05). Two years after the initial diagnosis, the blood flow density of deep retinal layer and choroidal capillaries layer in early ARMD patients further increased than before(P=0.02), ISOS-BRM thickness increased further than before(P=0.18). There was no significant change in the area of macular foveal, perimeter and acircularity index(P>0.05). In addition, the blood flow density of the choroidal capillary layer in early ARMD patients was positively correlated with the blood flow density in superficial retinal layer and deep retinal layer at baseline and two years after frist definite diagnosis.

CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer, and the thickness of inner layer retina in the patients with early ARMD decreased significantly, it is clinical reference significance for the early detection and intervention of ARMD.