Choriocapillaris impairment around the atrophic lesions in patients with geographic atrophy: a swept-source optical coherence tomography angiography study

Nassisi, Marco; Shi, Yue; Fan, Wenying; Borrelli, Enrico; Uji, Akihito; Ip, Michael S.; Sadda, Srinivas R

doi:10.1136/bjophthalmol-2018-312643

Cited by 81 publications

(64 citation statements)

References 37 publications

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“…Regardless, these regional differences in the CC that are accentuated by age must be taken into account in any studies comparing potential CC abnormalities in different parts of the macula. To address these regional differences, in a recent study evaluating CC flow deficits surround geographic atrophy lesions,[ 16 ] we compared regions at equal distances from the foveal center.…”

Section: Discussionmentioning

confidence: 99%

“…This hypothesis is supported by histologic studies which have demonstrated differences in the CC morphology in central compared to more peripheral regions [ 2 ]. These topographical variations in the CC may be significant confounders of studies which compare CC flow deficits within regions of interest in the macula [ 3 , 4 , 15 , 16 ]. To study the potential impact of these regional and age-related variations, we studied the topographical distribution of CC flow deficits in a cohort of normal subjects.…”

Section: Introductionmentioning

confidence: 99%

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Topographic distribution of choriocapillaris flow deficits in healthy eyes

et al. 2018

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PurposeTo evaluate the topographic distribution of the choriocapillaris (CC) flow deficits in a population of healthy subjects.MethodsUsing a swept-source optical-coherence tomography angiography (SS-OCTA) device, two repeated volume 6 x 6 mm and 3 x 3 mm scans were acquired in healthy subjects at the Doheny—UCLA Eye Centers. The en-face CC angiogram was binarized and analyzed for percentage of flow deficits (FD%) using a grid of progressive, concentric rings covering a circular area with a diameter of 2.5 mm (in the 3 x 3 mm scans) and 5 mm (in the 6 x 6 mm scans). The FD% for each ring was plotted against the distance from the fovea. The linear trendline of the resulting curve was analyzed and the slope (m) and intercept (q) were computed.ResultsSeventy-five eyes of 75 subjects were enrolled and divided into three subgroups based on age (year ranges: 21–40, 41–60 and 61–80). For the entire cohort and within each subgroup, there was a significant association between distance from the fovea and FD% in both 3X3 mm and 6X6 mm scans, with flow deficits increasing with closer proximity to the foveal center. Age was a significant predictor for both m and q for both scan patterns, with older subjects showing a steeper slope.ConclusionsIn SS-OCTA images, the topographic distribution of CC flow deficits varies with distance from the fovea and age. In particular, the FD% tends to decrease from the fovea towards the periphery, with a steeper decline with advancing age. These normal trends may need to be accounted for in future studies of the CC in disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Topographic distribution of choriocapillaris flow deficits in healthy eyes

et al. 2018

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“… 1 , 3 , 4 Recent optical coherence tomography angiography (OCTA) studies have shown that eyes with geographic atrophy exhibit greater CC flow deficits (FD) versus normal eyes and versus eyes with neovascular AMD and that CC impairment may predict the progression of geographic atrophy (GA). 5 – 7 …”

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confidence: 99%

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Scharf

Corradetti

Alagorie

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose To evaluate choriocapillaris (CC) flow deficits (FD) in eyes with treatment-naïve macular neovascularization (MNV) and to compare CC FD around exudative versus nonexudative MNV. Methods Treatment-naïve eyes with a diagnosis of either exudative or nonexudative AMD and type 1 MNV were included. Normal control eyes were age-matched to each AMD eye one to one. En face optical coherence tomography angiograms were analyzed for percentage of CC FD (FD%) in two concentric 500 µm rings, ring 1 and ring 2, surrounding the dark halo around MNV. The mean CC FD% in ring 1 and ring 2 was evaluated for each eye. A secondary analysis was similarly carried out to investigate the differences in CC FD% in exudative versus nonexudative treatment-naïve MNV. Results Twenty-three eyes with treatment-naïve MNV were age matched with 23 normal controls. The mean CC FD% was significantly greater in both rings in the MNV versus the normal control group ( P < 0.05) and was significantly greater in the inner ring, closer to the lesion, than the outer ring. The mean FD% was also greater in both rings in the exudative versus the nonexudative MNV group, but this difference did not reach statistical significance. Conclusions The CC FD% was greater in the area surrounding MNV versus age-matched normal controls and in the ring closer to the MNV lesion. Further, CC FD was greater in eyes with exudative versus nonexudative MNV in both rings surrounding the associated dark halo, although this difference was not statistically significant.

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“…With rare exception, there is an increase in both flow deficit metrics from the early stage through the advanced stage. This might be expected based on OCTA and histology studies that have found flow or vessel impairment beneath drusen and around GA lesions 17,[19][20][21][22] and progressively by dry AMD stage. 12,23 Even if stage is minimally contributory to flow deficit metrics, this trend is consistent with the findings of multiple studies of age in the CC, [7][8][9][10][11][12] as there was a respective increase in the mean ages of early, intermediate, and advanced eyes in our cohort (early, intermediate, and advanced eye mean ages: 72, 77, and 81 years, respectively).…”

Section: A Casementioning

confidence: 68%

Using the Pathophysiology of Dry AMD to Guide Binarization of the Choriocapillaris on OCTA: A Model

Braun

Mehta

Gendelman

et al. 2020

Trans. Vis. Sci. Tech.

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Choriocapillaris impairment around the atrophic lesions in patients with geographic atrophy: a swept-source optical coherence tomography angiography study

Abstract: A significant impairment of the CC flow is present in the zone immediately surrounding the GA lesions strengthening the hypothesis that CC alterations may be relevant to the progression of GA.

Cited by 81 publications

References 37 publications

Topographic distribution of choriocapillaris flow deficits in healthy eyes

Topographic distribution of choriocapillaris flow deficits in healthy eyes

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Using the Pathophysiology of Dry AMD to Guide Binarization of the Choriocapillaris on OCTA: A Model

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