How do choroidal metrics evolve with age? A Wide-Field Swept- Source OCT Angiography study

Abstract The purpose of this study is to establish age-stratified normative values for choroidal thickness (CT) and choroidal vascularity index (CVI) in healthy adult eyes using 24×20 mm widefield swept-source OCTA (WF-OCTA), and to evaluate regional variations across the posterior pole and retinal periphery. While CT is widely used to assess choroidal structure, it varies with physiologic factors such as age and refractive status. CVI has been proposed as a more stable marker because it reflects the proportion of vascular luminal area within the choroid. However, normative widefield data for CT and CVI across age groups remain limited. This was a cross-sectional observational study analyzing 24×20 mm WF-OCTA exams. A total of 122 eyes from 64 subjects were included. Choroidal thickness decreased considerably with age, with the strongest decline in the central sector. The age-related thinning was not homogeneous, showing regional variation across sectors. CVI remained relatively stable with age, with only limited sector-specific variation. CVI was generally highest in the superior-temporal sector and lowest in the central sector. Ultra-widefield OCTA provides useful normative data for assessing choroidal structure in healthy eyes. Our findings suggest that CVI may be a more robust biomarker for evaluating choroidal changes.