Choriocapillaris Flow Density Negatively Correlates With Advancing Age on Spectral-Domain Optical Coherence Tomography Angiography

Pettenkofer, Moritz; Scherm, Pauline; Feucht, Nikolaus; Wehrmann, K; Lohmann, Chris P.; Maier, Mathias

doi:10.3928/23258160-20190503-07

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…In our study, we evaluated the CFD of contralateral eyes of nAMD and PCV with OCTA, and found nAMD-contralateral eyes had significantly lower CFD compared with PCV and control eyes, while the difference wasn't statistically significant between PCV group and control. Although CFD was found negatively correlates with aging (17), it is unlikely that aging itself can account for the difference, since PCV and AMD group were age-matched. Another important factor is the existence of drusen, which is considered a hallmark of dry AMD.…”

Section: Discussionmentioning

confidence: 87%

Comparison of Choriocapillary Flow Density Between Fellow eyes of Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration

Luo

Yuan

Yang

et al. 2020

Preprint

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Background To compare the choriocapillary flow density (CFD) among the contralateral eyes of polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nAMD) and healthy controls with spectral-domain optical coherence angiography tomography (SD-OCTA).Methods This is a cross-sectional study. 36 eyes of 36 PCV patients, 35 eyes of nAMD patients and 34 control eyes were included. All sujects underwent the HD Angio Retina 6.0 mm scan pattern of OCTA (RTVue XR Avanti AngioVue; Optovue, Inc., Fremont, CA, USA). Circles with radius of 1.00, 1.50 and 3.00 mm were manually selected in choriocapillaries (CC) slab, and CFD was calculated as the percentage of flow area to the whole selected area as CFD-1.00, 1.50, 3.00 respectively. Multivariate linear regression analysis was performed to evaluate the differences of CFD among the three groups after adjusting for age, gender and the existence of drusen.Results Mean CFD-1.00, 1.50, 3.00 of nAMD group were 61.09, 62.65 and 65.67, significantly lower than PCV group (65.80, 66.75, 67.86, P= 0.000, 0.000, 0.022) and control (66.17, 66.45, 68.08, P= 0.000, 0.001, 0.025), while no difference were detected between PCV group and control ( P= 0.507, 0.798, 0.575).Conclusions CFD of nAMD fellow eyes were significantly lower than that of PCV and control eyes, while no difference was detected between PCV and control group, indicating different role of CC loss in early pathogenesis of nAMD and PCV.

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Section: Discussionmentioning

confidence: 87%

Comparison of Choriocapillary Flow Density Between Fellow eyes of Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration

Luo

Yuan

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In this study, we evaluated the CFD of fellow eyes of nAMD and PCV groups using OCTA and found that fellow eyes of the nAMD group had significantly lower CFD compared with the PCV and control group, and the differences between the PCV group and the control group or between PCV subtypes were not statistically significant. Although CFD was found to be negatively correlated with aging [19], it is unlikely that aging itself can account for the difference because the PCV, AMD, and control group were age-matched. Another important factor is the existence of drusen, which is considered a hallmark of dry AMD.…”

Section: Discussionmentioning

confidence: 94%

Comparison of choriocapillary flow density between fellow eyes of polypoidal choroidal vasculopathy and neovascular age-related macular degeneration

Luo

Zhao

et al. 2020

BMC Ophthalmol

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Background: To compare the choriocapillary flow density (CFD) among the fellow eyes of polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nAMD), and healthy controls using spectraldomain optical coherence angiography tomography (SD-OCTA). Methods: This is a cross-sectional study that includes the fellow eyes of 38 patients with unilateral PCV, 36 patients with unilateral nAMD, and 36 eyes from 36 healthy volunteers. The PCV group was further classified into polypoidal CNV (P-CNV) and typical PCV (T-PCV) for subgroup analysis. The age, subfoveal choroidal thickness (SFCT), Age-Related Eye Disease Study (AREDS) classification, and fellow eye diagnosis were acquired. All subjects underwent SD-OCTA with a 6.0-mm scan pattern. Circles with radius of 1.00, 1.50, and 3.00 mm were manually selected in the choriocapillaris (CC) slab, and the CFD was calculated as the percentage of the flow area to the whole selected area as CFD-1.00, 1.50, and 3.00, respectively. Univariate and multivariate analysis were performed to study the correlation between the aforementioned factors with CFD.

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“…Spacings of 5 to 20 mm in methacrylate casts of human posterior pole were reported by Olver 57 without individual values or methodologic details. Lengths of choriocapillaris lumens were incorporated only into vascular density, an aggregate measure, by Ramrattan et al 17 Reduced flow signal density, analogous to vessel density, and increased signal voids (reciprocal of vessel density) have been reported in normal aging, 58,59 early AMD, 60,61 and advanced AMD. 62e64 Published values vary widely (40%e>90% for vascular density) 65e67 and often are higher than histologic measures.…”

Section: Discussionmentioning

confidence: 99%

Nonexudative Macular Neovascularization Supporting Outer Retina in Age-Related Macular Degeneration

et al. 2020

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Purpose: Type 1 macular neovascularization (MNV) secondary to age-related macular degeneration (AMD) may sustain hypoxic and micronutrient-insufficient outer retinal cells compensatorily. We explored this hypothesis via histologic analysis of an eye with a shallow irregular retinal pigment epithelial elevation (SIRE) on OCT and good vision.Design: Case study and clinicopathologic correlation.Participant: A white woman with untreated nonexudative neovascular AMD and 20/30 visual acuity (left eye) and neovascular AMD (right eye), with 9 years' multimodal imaging before dying at 90 years of age.Methods: The left eye was preserved 6.25 hours after death and prepared for submicrometer epoxy resin sections and transmission electron microscopy aligned to clinical OCT B-scans. Inside and outside the MNV area, layer thicknesses, phenotypes, and vascular density of native choriocapillaris and neovessels were measured. Lengths of choriocapillaries and intervening gaps in the index eye and in early AMD eyes and healthy eyes with similar age (n ¼ 19 each) from the Project MACULA (Maculopathy Unveiled by Laminar Analysis) online histopathologic resource (http://projectmacula.cis.uab.edu/) were measured with custom software (Caps and Gaps).Main Outcome Measures: Descriptive features, vascular density, histologic and OCT layer thicknesses, and distribution of choriocapillaries and intervening gaps.Results: The SIRE correlated to a type 1 MNV that expanded slowly without evidence of exudation and with numerous choroidal vessels traversing Bruch's membrane defects, some visible on OCT. Tissue layers in and adjacent to the MNV area showed continuous RPE and characteristic AMD deposits. Capillary-like neovessels with fenestrations and caveolae resembling native choriocapillaris lined the retinal pigment epithelium (RPE) with a vascular density comparable with surrounding non-MNV areas. Relative to early AMD and healthy aged eyes, the index eye showed similar capillary lengths but larger gaps between vessels, indicating dropout. Outer nuclear layer thickness was preserved and showed less photoreceptor degeneration over areas of relative choriocapillaris health, including the type 1 MNV.Conclusions: Eyes with nonexudative type 1 MNV in AMD may progress to exudation, yet this stable MNV complex supported outer retinal structure for 9 years. Distinguishing features were numerous connecting vessels, high density of neovessels, continuous RPE, and slow growth. Maintaining beneficial type 1 MNV may be a therapeutic strategy. Ophthalmology 2020;127:931-947 ª 2020 by the American Academy of Ophthalmology Supplemental material available at www.aaojournal.org.Macular neovascularization (MNV), a major sight-threatening complication of age-related macular degeneration (AMD), occurs in 3 variants. 1 Type 1 MNV originates from the choroid and proliferates beneath the retinal pigment epithelium (RPE) and its basal lamina 2,3 (RPEþBL) and above the inner collagenous layer of Bruch's membrane (BrM). 4,5 When type 1 MNV extends anteriorly across the R...

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Choriocapillaris Flow Density Negatively Correlates With Advancing Age on Spectral-Domain Optical Coherence Tomography Angiography

Cited by 9 publications

References 21 publications

Comparison of Choriocapillary Flow Density Between Fellow eyes of Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration

Comparison of Choriocapillary Flow Density Between Fellow eyes of Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration

Comparison of choriocapillary flow density between fellow eyes of polypoidal choroidal vasculopathy and neovascular age-related macular degeneration

Nonexudative Macular Neovascularization Supporting Outer Retina in Age-Related Macular Degeneration

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