Concentric Choriocapillaris Flow Deficits in Retinitis Pigmentosa Detected Using Wide-Angle Swept-Source Optical Coherence Tomography Angiography

Miyata, Manabu; Oishi, Akio; Hasegawa, Tomoko; Oishi, Maho; Numa, Shogo; Otsuka, Yuki; Uji, Akihito; Kadomoto, Shin; Hata, Masaharu; Ikeda, Hanako Ohashi; Tsujikawa, Akitaka

doi:10.1167/iovs.18-26176

Cited by 22 publications

(16 citation statements)

References 22 publications

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“…Hagag A M et al also reported CC flow voids using 8 mm × 8 mm SD-OCTA in patients with different genotypes [ 7 ]. Manabu Miyata et al reported concentric choriocapillaris flow deficits with bare large choroidal vessels in RP using 12 mm × 12 mm SS-OCTA [ 6 ], which was consistent with our findings. In Miyata’s research, no relationship between preserved CC area and BCVA was found.…”

Section: Discussionsupporting

confidence: 92%

“…Since the peripheral retina is more easily affected in RP, large-range SS-OCTA is needed. Recent studies using 12 × 12 mm or 8 × 8 mm OCTA have found choriocapillaris flow voids or flow defects in certain regions of the retina [ 6 , 7 ], but the relationship between CC defects and retinal or choroidal structural changes has never been reported.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal vascular changes in retinitis pigmentosa patients detected by optical coherence tomography angiography

Shen

Wang

et al. 2020

BMC Ophthalmol

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Background To evaluate choroidal vascular changes, including choriocapillaris (CC) and middle/large choroidal vessels, in retinitis pigmentosa (RP) patients using wide-angle optical coherence tomography angiography (OCTA) and to determine whether changes in the choroidal vascularity have a relationship with visual function and retinal structural changes. Methods 34 patients with a confirmed diagnosis of RP and 48 controls were recruited. All patients underwent detailed ophthalmologic and imaging examinations, including two types of OCTA (Optovue, 3 × 3 mm, 6 × 6 mm; VG-200, 12 × 12 mm). CC defects were defined according to the choroidal vascular structure in five degrees. To evaluate middle and large choroidal vascular changes, the choroidal vascularity index (CVI), which was the luminance volume to the total choroidal volume, was used. Results Defects of choroidal vascularity of RP eyes were detected in comparison to control eyes. The defects were observed in the CC layer with a concentric or lobular pattern at different degrees. CVI, which was used to reflect middle/large choroidal vascularity, decreased in the perifoveal, pararetinal and periretinal regions in the RP eyes. CC defects degree were correlated with the BCVA (p = 0.001, r = − 0.556), the Humphrey indexes (mean deviation, MD, p < 0.001, r = − 0.673; PVF, p = 0.003, r = − 0.639; 10° mean sensitivity, 10° MS, p = 0.002, r = − 0.651) and microperimetry index (mean sensitivity, MS, p < 0.001, r = − 0.807). The preserved CC area (mean value: 28.65 ± 12.50 mm2) was negatively correlated with MS measured by microperimetry (p = 0.005, r = − 0.449). Ordinary regression analysis revealed that the CC defect degree was associated with the CVI of perifovea (p = 0.002, 95% CI: − 102.14 to − 24.01), the EZ length (p = 0.006, 95% CI: − 0.006 to − 0.001) and the VAD (vascular area density) of the DCP (deep capillary plexus) in the fovea (p = 0.022, 95% CI: 0.038–0.478). No correlations were detected between BCVA and CVI in any retinal regions. No correlations were found between the CVI and the VAD in any retinal regions. Conclusion The choroidal vascularity was widely defected in RP. Choriocapillaris and middle/large choroidal vascularity defects were correlated with each other. Visual function and retinal structural changes were found to be associated with choriocapillaris defects but not with middle/large choroidal vascular defects.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Choroidal vascular changes in retinitis pigmentosa patients detected by optical coherence tomography angiography

Shen

Wang

et al. 2020

BMC Ophthalmol

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“…and Guduru showed that the number and area of flow voids in the choriocapillaris were higher in RP eyes when compared to controls [29]. A qualitative study using wide angle swept source OCTA by Miyata and colleagues, with 43 RP eyes and 12 healthy eyes, demonstrated that concentric and vermicular choriocapillaris flow deficits were observed in 23% and 40% of RP eyes, respectively, and 0% of healthy eyes [38]. However, other studies showed no difference in choriocapillaris flow parameters between RP and control eyes [28,31,34].…”

Section: Octa In Retinitis Pigmentosamentioning

confidence: 98%

“…Some authors have attributed this discrepancy to the size of OCTA images captured. Narrow angle OCTA with dimensions of 3 × 3 mm is thought to miss choriocapillaris changes that occur outside the macular center [38].…”

Section: Octa In Retinitis Pigmentosamentioning

confidence: 99%

Optical Coherence Tomography Angiography Imaging in Inherited Retinal Diseases

Ong

Patel

Singh

2019

JCM

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Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging modality that allows depth-resolved imaging of the microvasculature in the retina and the choroid. It is a powerful research tool to study the pathobiology of retinal diseases, including inherited retinal dystrophies. In this review, we provide an overview of the evolution of OCTA technology, compare the specifications of various OCTA devices, and summarize key findings from published OCTA studies in inherited retinal dystrophies including retinitis pigmentosa, Stargardt disease, Best vitelliform macular dystrophy, and choroideremia. OCTA imaging has provided new data on characteristics of these conditions and has contributed to a deeper understanding of inherited retinal disease.

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“…Several recent studies conducted with OCTA have reported a reduction of retinal vessel density and retinal perfusion density, impaired choroidal blood flow, or significantly altered sizes of the foveal avascular zones in eyes of patients suffering from RP [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Given the known microvascular alterations in RP, it might be beneficial to use OCTA in the context of TES treatment.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

Zabek

Zuche

Müller

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Transcorneal electrical stimulation (TES) is a novel treatment approach for patients with retinitis pigmentosa (RP). The aim of our study was to observe changes in optical coherence tomography angiography (OCTA) that would be attributed to TES treatment. Methods A total of 73 eyes were included: 43 eyes of 22 subjects (11 ♀, 11 ♂) suffering from RP were examined at baseline (BL), after first stimulation (TS), 1 week (1W), and 6 months (6M) after treatment initiation and were compared with 30 control eyes of 15 subjects (8 ♀, 7 ♂). TES was performed simultaneously on both eyes for 30 min weekly. OCTA scans of 9 × 15 mm were recorded with a PLEX Elite 9000 swept-source OCTA device (Carl Zeiss Meditec AG, Jena). Vascular density metrics such as perfusion density (PD) and vessel density (VD) were calculated automatically for the macular area by using standardised extended early treatment diabetic retinopathy study (ETDRS) grids centred around the fovea. In addition, the capillary perfusion density (CPD) and the capillary flux index (CFI) of the peripapillary nerve fibre layer microvasculature in all four quadrants of an annulus centred at the optic disc were measured. All parameters were determined over all retinal layers and separately for the superficial (SCP) and deep capillary plexus (DCP). ANOVA-based linear mixed-effects models were calculated with SPSS®. Results Throughout the course of TES treatment, the macular VD and PD of all retinal layers in all subsections showed a slight decrement without reaching statistical significance, also when analysed separately in the SCP and DCP (p > 0.08). In analogy, the average CPD and CFI also presented with a slight decrement (p > 0.20). However, when compared with controls, most OCTA parameters showed a significant decrement (p < 0.05). When analysed systematically in all subsections of the extended ETDRS grid, the temporal macular subsections within the outer ring (radius 1.5–3 mm) and also of the peripheral C1, C2, and C3 rings (radius 3–7.5 mm) showed lower VD and PD values when compared with the other subsections (p < 0.05). Conclusion Vascular density metrics in the macular region and the peripapillary microvasculature appear to remain unaffected by continuous TES treatment within a period of 6 months.

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Concentric Choriocapillaris Flow Deficits in Retinitis Pigmentosa Detected Using Wide-Angle Swept-Source Optical Coherence Tomography Angiography

Cited by 22 publications

References 22 publications

Choroidal vascular changes in retinitis pigmentosa patients detected by optical coherence tomography angiography

Choroidal vascular changes in retinitis pigmentosa patients detected by optical coherence tomography angiography

Optical Coherence Tomography Angiography Imaging in Inherited Retinal Diseases

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

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