Reduced Choriocapillaris Flow in Eyes With Type 3 Neovascularization and Age-Related Macular Degeneration

Borrelli, Enrico; Souied, Eric H.; Freund, K. Bailey; Querques, Giuseppe; Mière, Alexandra; Gal-Or, Orly; Sacconi, Riccardo; Sadda, Srinivas R; Sarraf, David

doi:10.1097/iae.0000000000002198

Cited by 114 publications

(83 citation statements)

References 47 publications

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“…Borrelli et al report in a retrospective analysis that a significantly greater percentage of non-perfused areas in the choriocapillaris can be measured by OCT-A in eyes with type 3 neovascularisation compared with their healthy partner eyes. These healthy partner eyes also show more non-perfused areas in the choriocapillaris than the healthy partner eyes of patients with type 1 or 2 neovascularisation [21]. These results are consistent with previous studies in which significantly thinner subfoveal choroid was found by OCT (enhanced depth imaging) in eyes with type 3 neovascularisation compared with eyes with typical exudative AMD [22] and healthy eyes [23].…”

Section: Discussionsupporting

confidence: 91%

OCT Angiographic Findings in Retinal Angiomatous Proliferation

Heine

Schick

Lang

2020

Klin Monbl Augenheilkd

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Background OCT angiography (OCT-A) allows non-invasive blood flow registration of the retina and choroid. In contrast to fluorescein angiography (FA), no dye has to be administered. The OCT-A also provides depth-selective information. OCT-A and FA were compared in patients with neovascular age-related macular degeneration (AMD) with retinal angiomatous proliferation (RAP) stage 1. In stage 1, the neovascularizations are intraretinal. In contrast to the two-dimensional total image of the FA, the OCT-A allows a depth-selective display of the individual retinal layers. In this way, a conclusion can be drawn about the place of origin of the RAP. Patients and Methods Three patients with neovascular AMD and RAP stage 1 were included. They were examined with OCT (ZEISS CIRRUS HD-OCT 5000, Carl Zeiss Meditec, Inc., Dublin, USA), OCT-A (ZEISS AngioPlex OCT-Angiography) as well as FA (HRA2, Heidelberg Engineering) between January 2016 and March 2019. A complete ophthalmological examination was performed. A qualitative analysis of the OCT-A images (3 × 3 and 6 × 6 mm) and the FA images was carried out. Leaks in the FA were compared with the en-face images of the OCT-A followed by a depth-selective assignment using the corresponding B-scans of the OCT-A. Results It was one woman and two men aged 66 – 89 years. The visual acuity was 0.4 in the first, 0.5 p in the second and 0.8 in the third patient. The diagnosis of RAP stage 1 could be made both in the OCT, the FA and the OCT-A. All patients showed macular edema in the OCT. The FA showed selective hyperfluorescence in the early phase and fluorescein extravasation in the late phase. In OCT-A, the blood flow in all patients could be shown in the hyperreflective structure of the RAP in the B-scan. The first patient showed two RAP lesions in the FA, which were in the deep vascular plexus in the OCT-A. In the second patient, three RAP lesions were found in the FA, and a total of five RAP lesions in the OCT-A. One could be located in the superficial and deep vascular plexus, four in the deep vascular plexus. The third patient showed one RAP lesion in the FA as well as in the OCT-A, which could be assigned to the superficial vascular plexus. Conclusion The OCT-A is well suited for the diagnosis of RAP stage 1. In the present cases, the diagnosis in the OCT-A could be made as clearly as by FA. A major advantage of the OCT-A results from the non-invasive character and the depth selectivity. The RAP 1 lesions could be assigned to both the superficial and the deep vascular plexus. Depth selection is not possible with the FA due to the summary picture.

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Section: Discussionsupporting

confidence: 91%

OCT Angiographic Findings in Retinal Angiomatous Proliferation

Heine

Schick

Lang

2020

Klin Monbl Augenheilkd

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“…() found that nonperfused CC area detected on OCT‐A correlated to decreased visual acuity in a group of eyes with drusen and pseudodrusen; Borrelli et al. () observed a correlation between FVs area and N1 multifocal electroretinogram implicit times in iAMD, thus supporting the hypothesis of an association between CC perfusion and photoreceptor function.…”

Section: Discussionmentioning

confidence: 91%

“…Moreover, a higher average CC signal void size was reported in eyes with early and iAMD and type 3 neovascularization in the fellow eye versus early and iAMD and type 1 or 2 neovascularization in the fellow eye (Borrelli et al. ,b,c). It is clearly established that patients with nAMD in one eye have a higher risk of developing nAMD in the fellow eye, therefore, these data may support the hypothesis that CC impairment could drive the development of neovascular form of AMD.…”

Section: Discussionmentioning

confidence: 99%

Quantitative choriocapillaris evaluation in intermediate age‐related macular degeneration by swept‐source optical coherence tomography angiography

Vujosevic

Toma

Muraca

et al. 2019

Acta Ophthalmologica

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Purpose: To investigate choriocapillaris (CC) perfusion, by evaluating flow voids (FV), in eyes with intermediate age-related macular degeneration (iAMD) using swept-source optical coherence tomography angiography (SS-OCT-A). Methods: Patients with bilateral or unilateral iAMD and normal controls underwent SS-OCT and OCT-A examination. Choriocapillaris (CC) FVs were quantitatively assessed on OCT-A images using MATLAB (version 2017b; MathWorks, Natick, MA, USA), after a preprocessing aimed at compensating for CC attenuation artefacts. Three different thresholds [1 standard deviation (SD), 1.25 SD and 1.5 SD] were applied. Final FV percentage (FV%) was calculated as the ratio between area with absent flow and total scanned area. Results: Of 41 patients with iAMD and 16 normal subjects enrolled in the study, 39 eyes (39 patients) with iAMD and all 16 normal eyes (16 control subjects) were included in the final analysis. Mean FV% (1 SD) was 13.45 AE 0.66 in controls, 14.19 AE 1.23 in bilateral iAMD and 14.21 AE 0.99 in unilateral iAMD (p = 0.03, for difference between controls and bilateral iAMD). Mean FV% (1.25 SD) was 6.55 AE 0.65 in controls, 7.33 AE 1.4 in bilateral iAMD and 7.06 AE 1.4 in unilateral iAMD (p = 0.048, for difference between controls and bilateral iAMD). Mean FV% (1.5 SD) was 2.71 AE 0.82 in controls, 2.55 AE 1.12 in bilateral iAMD and 3.25 AE 1.17 in unilateral iAMD (p = 0.038, for difference between bilateral and unilateral iAMD). Conclusion: A significantly higher FV% was found in patients with iAMD versus controls. A higher trend in FV% was found in unilateral iAMD (with neovascular AMD in the fellow eye) versus bilateral iAMD, when applying the lowest threshold. Further, larger and longitudinal studies are needed to confirm this data.

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“…Several studies assessed the retinal and choroidal vasculature in eyes with iAMD and showed that iAMD eyes are characterized by a reduced SCP and CC perfusion density, especially in the presence of nascent geographic atrophy or neovascularization in the fellow eye. 21,[25][26][27][28] The average signal void size of the CC and PNPCA were recently characterized in eyes with iAMD using spectral domain optical coherence tomography angiography. 21 In the latter study, OCTA data from 42 iAMD eyes (42 patients) and 20 eyes from 20 healthy individuals were retrospectively collected.…”

Section: Discussionmentioning

confidence: 99%

Impact of Choriocapillaris Flow on Multifocal Electroretinography in Intermediate Age-Related Macular Degeneration Eyes

Borrelli

Mastropasqua

Senatore

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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Reduced Choriocapillaris Flow in Eyes With Type 3 Neovascularization and Age-Related Macular Degeneration

Abstract: Eyes with unilateral Type 3 NV illustrated increased CC nonperfusion versus fellow nonneovascular eyes. These results suggest that choroidal ischemia may play an important role in the development of Type 3 NV.

Cited by 114 publications

References 47 publications

OCT Angiographic Findings in Retinal Angiomatous Proliferation

OCT Angiographic Findings in Retinal Angiomatous Proliferation

Quantitative choriocapillaris evaluation in intermediate age‐related macular degeneration by swept‐source optical coherence tomography angiography

Impact of Choriocapillaris Flow on Multifocal Electroretinography in Intermediate Age-Related Macular Degeneration Eyes

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