Characterization of Choroidal Morphology and Vasculature in the Phenotype of Pachychoroid Diseases by Swept-Source OCT and OCTA

Abstract

The objective of this study was to characterize the choroidal morphology and vasculature in pachychoroid diseases (PCD). A total of 49 eyes with polypoidal choroidal vasculopathy (PCV), 43 eyes with neovascular age-related macular degeneration (nAMD), and 50 eyes with central serous chorioretinopathy (CSC), along with 80 healthy eyes, were enrolled in this nested case-control study. The swept-source optical coherent tomography (OCT), OCT angiography, and En face images were quantitatively analyzed. Multivariate logistic regression models showed that older age and increased vessel density (VD) in the choriocapillaris (CC) layer were independent risk factors for both PCV (page < 0.001, pVD = 0.004), and nAMD (page < 0.001, pVD = 0.005). Decreased VD in the Sattler’s layer was an independent risk factor for PCV (p = 0.014). Increased VD in the Haller’s layer was an independent risk factor for CSC (p = 0.001). The proportion of the diffuse type of collateral circulation in the Sattler’ layer in CSC group was significantly higher than in the other three groups (p < 0.001). We concluded that the involvement of the blood flow in the CC, Haller’s, and Sattler’s layers are differently affected in CSC, nAMD, and PCV eyes, indicating the different pathological mechanism underlying the phenotype of PCD. The age-dependent establishment of collateral circulation in the Sattler’s layer may play a compensatory role regarding ischemic injury in the development of PCD.

Evaluation of Choroidal Structure in Type 1 Macular Neovascularization Using Different Optical Coherence Tomography Analyses: Scale Bar and Binarization

“…On the other hand, there was no significant difference in CVD between the two groups in our study. A recent study suggested that decreased vascular density in the superficial choroid is an independent risk factor for polyp development [ 31 ]. Thinning of the superficial layer may be responsible for the reduced vascular density.…”

Vortex vein engorgement and different shapes of venous drainage systems in polypoid choroidal vasculopathy vs. age‑related macular degeneration on indocyanine green angiography

“…If the disease progresses, the terminal blood vessels bulge locally and manifest as polypoid lesions (12,14). Qiu et al (15) found statistically significant differences in the proportion of diffuse collateral circulation between PCV, neovascular AMD, central serous chorioretinopathy (CSC) and healthy controls. During the progression of pachychoroid spectrum disease, hyperaemia of the vortex veins may gradually improve with the development of anastomosis between the superior and inferior vortex veins (16).…”

Efficacy and Predictive Factors of Oral Spironolactone Treatment in Chronic Central Serous Chorioretinopathy

“…Substandard scans in which the signal strength (SS) fell below the manufacturer's recommended cut-off point (SS < 7) and images with significant eye movement were excluded. Choriocapillaris density (CCD) was measured by OCTA, and Sattler + Haller vessel density was quantified by en face images to avoid sensitivity roll-off with increasing imaging depth [ 10 , 11 ]. To avoid the shadowing effect of neurosensory detachment that affects the OCTA flow signal in the choriocapillaris, we applied the CCD of a fellow eye for analysis [ 12 ].…”