Comparative analysis of autofluorescence and OCT angiography in Stargardt disease

Abstract

RPE damage on FAF appears to be significantly larger than CC layer vessel loss on OCTA, which suggests that RPE damage might precede that of CC.

Optical Coherence Tomography Angiography Imaging in Inherited Retinal Diseases

“…Guduru et al compared RPE atrophy on fundus autofluorescence imaging and hypointensity at the choriocapillaris layer on OCTA in 22 STGD patients (43 eyes), and found that the RPE atrophy area (6.7 ± 4.4 mm 2 ) was larger than the choriocapillaris hypointense area (4.2 ± 3.6 mm 2 ) (p = 0.004). Those data suggested that RPE damage may precede choriocapillaris atrophy in STGD [43]. Functionally, Mastropasqua and colleagues examined 17 eyes from 9 patients with STGD and found that the percent perfused choriocapillaris area was associated with retinal sensitivity analyzed by microperimetry (p < 0.001), thereby suggesting the possibility of utilizing choriocapillaris dysfunction as a predictor for retinal function in STGD patients [44].…”

Hereditäre Netzhautdystrophien: Kombination ophthalmologischer Methoden zur Optimierung des Readout

“…Die OCTA ist geeignet, die Progression makulärer vaskulärer Veränderungen bei Retinitis pigmentosa im Verlauf zu messen [38]. Beim Morbus Stargardt ist die FAF sensitiver als die OCTA [39].…”

Novel Insight into Morphological Features and Vascular Profile of Selected Macular Dystrophies Using Swept-Source Optical Coherence Tomography and Optical Coherence Tomography Angiography

“…These findings purported a cause-effect relationship between the morphological changes seen in retinal microstructure and the status of vascular nourishment, in the sense that one pathology is a consequence of the other, though the exact mechanism remains debatable [13][14][15]. One theory proposes that the progressive demise of photoreceptors and RPE causes a thinning out of the retina with subsequent progressive atrophy of retinal vasculature and choriocapillaris as part of a downregulation process due to a reduced vascular demand [16]. Another proposed mechanism is that retinal thinning due to the loss of photoreceptors and RPE allows more oxygen influx into the inner retinal layers from the choroidal circulation.…”

“…Another plausible theory is that progressive RPE loss results in a decreased release of vascular endothelial growth factor (VEGF) and other signaling factors that are essential for the viability of the choriocapillaris, hence precipitating choriocapillaris atrophy [17][18][19]. Finally, some researches propose that mechanical compression by the lipofuscin-laden RPE and accumulation of hyaline deposits between the RPE and Bruch's membrane exerts mechanical compression on the choriocapillaris with subsequent atrophy and loss [16].…”

“…These morphological changes are attributed to the patchy loss of choriocapillaris or to the masking effect of the pisciform flecks [15,29]. In some cases, there is enhanced visualization of the underlying Sattler's layer [16]. In terms of retinal capillary plexuses, vascular alterations of the SCP layer include rarefaction of the peri-foveal arcade with the enlargement of the foveal avascular zone (FAZ), and generalized reduction of vessel density in the SCP and the DCP layers, though these changes are most pronounced in the DCP layer [15,28,29].…”