Visualization of Changes in the Choriocapillaris, Choroidal Vessels, and Retinal Morphology After Focal Laser Photocoagulation Using OCT Angiography

Cole, Emily; Novais, Eduardo Amorim; Louzada, Ricardo Noguera; Moult, Eric M.; Lee, Byung-Kun; Witkin, André J.; Waheed, Nadia K.; Duker, Jay S.; Baumal, Caroline R.

doi:10.1167/iovs.15-18473

Cited by 26 publications

(22 citation statements)

References 38 publications

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“…The exclusion criteria were the presence of other chorioretinal diseases, glaucoma or ocular hypertension; an axial length shorter than 22.0 mm or longer than 26.0 mm; intraretinal or preretinal hemorrhages or hard exudates with diameters larger than one-third of the disc diameter within the central 3 × 3-mm square on the color fundus photograph; a history of any intervention for macular lesions; intraocular surgery other than cataract extraction; and cataract surgery within 6 months of study enrollment. We excluded eyes with a history of photocoagulation of the macular area because the decorrelation signals in the choriocapillaris layer were attenuated after this treatment 49 . To guarantee image quality, we also excluded eyes with a signal strength index (SSI) score of 60 or less 50 .…”

Section: Methodsmentioning

confidence: 99%

Clinical relevance of reduced decorrelation signals in the diabetic inner choroid on optical coherence tomography angiography

Dodo

Suzuma

Ishihara

et al. 2017

Sci Rep

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Diabetes induces lesions of the retinal and choroidal capillaries, which promote the pathogenesis of diabetic retinopathy (DR). The decorrelation signals in optical coherence tomography angiography (OCTA) represent the blood flow and vascular structure, and three-dimensional OCTA images enable individual capillary layers to be evaluated separately. The current study documented that en-face OCTA images revealed spots of flow void in the choriocapillaris layer in eyes with DR. Quantitative investigation demonstrated that non-flow areas within the central subfield (CSF) increased in eyes with more severe DR grades. The non-flow areas in the choriocapillaris layer were also associated with poorer visual acuity (VA) in all 108 eyes. A modest correlation was noted between the areas of flow void and poorer VA in 69 eyes without DME, whereas the non-flow areas were not related to VA or to CSF thickness measured by OCT in 39 eyes with DME. In 12 eyes with ischemic maculopathy, the choriocapillaris layer beneath the disrupted ellipsoid zone of the photoreceptor (EZ) had greater areas of flow void than did the area beneath an intact EZ. These data suggested that disrupted choroidal circulation has clinical relevance and contributes to the pathogenesis of DR.

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Section: Methodsmentioning

confidence: 99%

Clinical relevance of reduced decorrelation signals in the diabetic inner choroid on optical coherence tomography angiography

Dodo

Suzuma

Ishihara

et al. 2017

Sci Rep

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“…This study showed changes in the choriocapillaris on manually segmented images, but, in most cases, there were no changes in the superficial or deep retinal vasculature in the region of focal laser. In some cases, there were changes in the outer plexiform layer on OCT structural scans (Cole, Novais et al 2016). OCT-based studies have also suggested that focal laser does not significantly alter the anatomy of the inner retina (Bolz, Kriechbaum et al 2010), but histologic studies performed on monkey models of focal laser injury to the retina (Wilson, Finkelstein et al 1988) demonstrate decreased capillary density in the region of focal laser.…”

Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

768

561

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OCT has revolutionized the practice of ophthalmology over the past 10 to 20 years. Advances in OCT technology have allowed for the creation of novel OCT-based methods. OCT-Angiography (OCTA) is one such method that has rapidly gained clinical acceptance since it was approved by the FDA in late 2016. OCTA images are based on the variable backscattering of light from the vascular and neurosensory tissue in the retina. Since the intensity and phase of backscattered light from retinal tissue varies based on the intrinsic movement of the tissue (e.g. red blood cells are moving, but neurosensory tissue is static), OCTA images are essentially motion-contrast images. This motion-contrast imaging provides reliable, high resolution, and non-invasive images of the retinal vasculature in an efficient manner. In many cases, these images are approaching histology level resolution. This unprecedented resolution coupled with the simple, fast and non-invasive imaging platform have allowed a host of basic and clinical research applications. OCTA has been shown to demonstrate many important clinical findings including areas of macular telangiectasia, impaired perfusion, microaneurysms, capillary remodeling, some types of intraretinal fluid, and neovascularization among many others. More importantly, OCTA provides depth-resolved information that has never before been available. Correspondingly, OCTA has been used to evaluate a spectrum of retinal vascular diseases including diabetic retinopathy (DR), retinal venous occlusion (RVO), uveitis, retinal arterial occlusion, and age-related macular degeneration among others. In this review, we will discuss the methods used to create OCTA images, the practical applications of OCTA in light of invasive dye-imaging studies (e.g. fluorescein angiography) and review clinical studies demonstrating the utility of OCTA for research and clinical practice.

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“…Due to a high concentration of melanin, which absorbs a great deal of the energy, the RPE is the main target of laser photocoagulation [9]. Considering that the choriocapillaris is adjacent to the RPE and the melanin in the choroidal stroma can also absorb the laser energy, the choriocapillaris is likely to be affected by laser photocoagulation.…”

Section: Introductionmentioning

confidence: 99%

“…Although indocyanine green angiography (ICGA) is often used to evaluate the choroidal microcirculation, it is sometimes difficult to visualize the blood flow in the choriocapillaris due to rapid leakage of the ICG dye from the choriocapillaris that then stains Bruch's membrane and the choroidal stroma [15,16]. Optical coherence tomography angiography (OCTA) is a new imaging technology that provides depth-resolved visualization of the retinal microvasculature and the choriocapillaris without the need for dye injection [9,[15][16][17][18]. It performs multiple repeated B-scans in the same retinal area to differentiate the moving erythrocytes in the vasculature from the static fundus structure [15,17].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Dynamic Alteration of Choriocapillaris Vessel Density after Focal Laser Photocoagulation with OCT Angiography

Xing

Chen

et al. 2020

Journal of Ophthalmology

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Purpose. To evaluate the changes of choriocapillaris blood flow beneath laser lesions in noncenter-involved diabetic macular edema patients using optical coherence tomography angiography (OCTA). Methods. This was a retrospective case-series study. We used OCTA to analyze the characteristics of the choriocapillaris blood flow beneath laser lesions before laser treatment and at several intervals after treatment. The choriocapillaris vessel density (CCVD) beneath the laser lesions was based on the OCTA images and was defined as the proportion of flow pixels in the selected area calculated using FIJI software through automatic binarization processing based on threshold methods. Results. A total of 63 laser lesions in 8 eyes of 5 patients were included in this study. There was a significant decrease in the CCVD at 1 hour and 1 day following laser treatment (24.25% ± 5.04% and 22.00% ± 4.71%, respectively) when compared with the baseline value (39.09% ± 3.71%, all p<0.001). The CCVD was 31.82% ± 4.53% in 1 week after laser treatment, which was significantly higher than that in 1 day after treatment (p<0.001), and then continued to improve at 1 month after treatment (34.44% ± 4.16%). Additionally, in the group with smaller spot size and lower energy, the CCVD recovery at 1 month after laser was significantly better than that in the group with larger spot size and higher energy (p=0.006). Conclusions. OCTA image analysis can reflect changes in the choriocapillaris blood flow beneath laser lesions at different times following laser treatment in vivo. Spot size and laser energy may affect blood flow recovery.

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Visualization of Changes in the Choriocapillaris, Choroidal Vessels, and Retinal Morphology After Focal Laser Photocoagulation Using OCT Angiography

Abstract: Optical coherence tomography angiography can be used to visualize choriocapillaris alterations associated with focal laser photocoagulation treatment.

Cited by 26 publications

References 38 publications

Clinical relevance of reduced decorrelation signals in the diabetic inner choroid on optical coherence tomography angiography

Clinical relevance of reduced decorrelation signals in the diabetic inner choroid on optical coherence tomography angiography

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Assessment of the Dynamic Alteration of Choriocapillaris Vessel Density after Focal Laser Photocoagulation with OCT Angiography

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