Choriocapillaris Flow Impairments in Association with Pachyvessel in Early Stages of Pachychoroid

Baek, Jiwon; Lee, Kook; Lee, Won Ki

doi:10.1038/s41598-019-42052-w

Cited by 48 publications

(25 citation statements)

References 19 publications

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“…This can either be attributed to a diminished but persistent shadowing artifact or alternatively hypoperfusion of the CC in patients with CSC. The latter would be in line with studies demonstrating a reduced OCTA flow in patients with CSC [ 8 , 17 , 23 , 24 ]—potentially the result of low blood flow [ 25 , 26 ], defective CC endothelial cells [ 27 , 28 ] or a thinned CC being pushed upward by pachyvessels accompanied by enlarged vascular space in Haller’s layer [ 17 , 24 , 29 , 30 ]. Nicolò et al [ 31 ] examined quantitative changes in choroidal flow areas using SS-OCTA and reported on dark patterns in the choroid regardless of the amount of fluid in CSC or in fellow eyes—anomalies not observed in healthy eyes.…”

Section: Discussionsupporting

confidence: 81%

“…The x-axis describes the density of flow signal changes in the respective area, the y-axis the probability of the corresponding percentage. Note that the distributions of SD-OCTA are uniformly broader in comparison with the distribution from SS-OCTA: This hints towards a better signal-to-noise ratio from the latter imaging modality [17,24,29,30]. Nicolò et al [31] examined quantitative changes in choroidal flow areas using SS-OCTA and reported on dark patterns in the choroid regardless of the amount of fluid in CSC or in fellow eyesanomalies not observed in healthy eyes.…”

Section: Discussionmentioning

confidence: 99%

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Swept-source optical coherence tomography angiography alleviates shadowing artifacts caused by subretinal fluid

et al. 2020

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Purpose To characterize the choriocapillaris (CC) structure in relation to subretinal fluid (SRF) as a possible systematic error source using spectral domain (SD-OCTA) compared to swept-source optical coherence tomography angiography (SS-OCTA). Methods This is a prospective case-control study of 23 eyes. Ten patients with acute central serous chorioretinopathy (CSC), three patients with partial macular-off retinal detachment (RD) and ten healthy, age-matched controls were included. Abnormal CC decorrelation signals were quantitatively compared in CSC and controls by means of custom image processing. To investigate the influence of SRF on CC OCTA signal, the extent of SRF was quantified with a macular heatmap and compared with the corresponding OCTA signal of the CC. Results SS-OCTA yielded a more homogeneous OCTA signal from the CC than SD-OCTA, offering less signal dispersion and variability in healthy and diseased eyes. Both devices demonstrated CC signal voids in CSC and RD, respectively. In CCS, the voids were predominantly located in the area with SRF. Compared to SD-OCTA, SS-OCTA delivered a more homogenous OCTA signal and reduced signal voids in the CC underneath SRF in both RD and CSC (CSC, 7.6% ± 6.3% vs, 19.7% ± 9.6%, p \ 0.01). Despite this significant attenuation of signal voids, SS-OCTA continued to reveal signal voids below SRF and more pixels with reduced OCTA signals in CSC patients compared to controls (7.6% ± 6.3%, 0.1% ± 0.1%, p \ 0.0001). Conclusion Understanding OCTA artifacts is critical to ensure accurate clinical evaluations. In this study, we describe the presence of SRF as an important shadow-causing artifact source for CC OCTA analysis which can be mitigated but not completely eliminated by employing SS-OCTA.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Swept-source optical coherence tomography angiography alleviates shadowing artifacts caused by subretinal fluid

et al. 2020

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“…In our study, the group with pachydrusen had a thicker CT profile compared to AMD groups, which is consistent with previous studies 35 , 38 , 40 . Recent findings that pachyvessel is a general phenomenon of PSDs and pachydrusen, and that focal ischemia caused by pachyvessels affects the development of these lesions, suggests that pachydrusen may have the common pathogenesis as PSDs 5 , 14 , 40 , 41 . Indeed, the finding of the current study that eyes with pachydrusen had a greater tendency to be clustered with eyes of PSD groups than with the AMD groups with soft drusen or exudation could support this suggestion.…”

Section: Discussionmentioning

confidence: 99%

Clustering of eyes with age-related macular degeneration or pachychoroid spectrum diseases based on choroidal thickness profile

Kim

Lee

Kang

et al. 2021

Sci Rep

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Choroidal changes have been suggested to be involved in the pathophysiology of both age-related macular degeneration (AMD) and pachychoroid spectrum diseases (PSD). To find out the choroidal characteristics of each disease groups, various groups of AMD and PSD were classified into several clusters according to choroidal profiles based on subfoveal choroidal thickness (CT), peripapillary CT, the ratio of subfoveal CT to peripapillary CT and age. We retrospectively analyzed 661 eyes, including 190 normal controls and 471 with AMD or PSDs. In the AMD groups, eyes with soft drusen or reticular pseudodrusen were belonged to the same cluster as those with classic exudative AMD (all p < 0.001). However, eyes with pachydrusen were not clustered with eyes from other AMD groups; instead, they were classified in the same cluster as eyes from the PSD group (all p < 0.001). In the PSD group, eyes with pachychoroid neovasculopathy were grouped in the same cluster of those with polypoidal choroidal vasculopathy (p < 0.001). The cluster analysis based on the CT profiles, including subfoveal CT, peripapillary CT, and their ratio, revealed a clustering pattern of eyes with AMD and PSDs. These findings support the suggestion that pachydrusen has the common pathogenesis as PSD.

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“…The results of a recent study showed that pachyvessels were associated with choriocapillaris flow impairment by location and size [22]. Whether the occurrence of dilated Haller pachyvessels is a primary event or secondary to the inner choroidal attenuation is still under investigation.…”

Section: 029*mentioning

confidence: 99%

Clinical implications of pachyvessels in polypoidal choroidal vasculopathy

et al. 2020

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Background: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8%). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (−) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P = 0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid (P = 0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (−) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.

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Choriocapillaris Flow Impairments in Association with Pachyvessel in Early Stages of Pachychoroid

Cited by 48 publications

References 19 publications

Swept-source optical coherence tomography angiography alleviates shadowing artifacts caused by subretinal fluid

Swept-source optical coherence tomography angiography alleviates shadowing artifacts caused by subretinal fluid

Clustering of eyes with age-related macular degeneration or pachychoroid spectrum diseases based on choroidal thickness profile

Clinical implications of pachyvessels in polypoidal choroidal vasculopathy

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