Choroidal structural analysis and vascularity index in retinal dystrophies

Wei, Xin; Mishra, Chitaranjan; Kannan, Naresh Babu; Holder, Graham E.; Khandelwal, Neha; Ramasamy, Kim; Agrawal, Rupesh

doi:10.1111/aos.13836

Cited by 29 publications

(24 citation statements)

References 43 publications

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“…The choroid vascularity index (CVI) is a useful measurement for evaluating the middle and large choroid vessels, especially in choroidal hyperfusion diseases such as central serous chorioretinopathy [ 2 ] as well as degenerative diseases such as Stargardt disease [ 16 ]. Several reports on RP have reported that CVI decreases in B-scans passing through the fovea [ 9 , 17 ]. Choroidal flow in the central 2.4 mm × 2.4 mm area was also assessed by using laser speckle flowgraphy (LSFG) [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…CVI has been used to represent the choroidal vessel condition in central serous chorioretinopathy [8]. Previous studies on retinal dystrophies have revealed a decrease of CVI in comparison to that of normal controls [9]. However, these studies all focused on one B-scan passing through the fovea but did not investigate the perifoveal region, which would be more likely to be affected in RP eyes.…”

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: Discussionmentioning

confidence: 99%

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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“…Choroidal vascular changes may contribute to the primary pathology of photoreceptor and RPE in inherited retinal disorders. CVI has been recently proposed as a novel OCT-based parameter to quantify structural changes in eyes with retinal dystrophies [22].…”

Section: In Inherited Retinal Disordersmentioning

confidence: 99%

“…In a retrospective case control study, Wei et al assessed CVI in patients affected by retinitis pigmentosa (RP) (n = 17), Stargardt disease (SD) (n = 4), cone-rod dystrophy (n = 3), Best disease (n = 1), and Bietti crystalline dystrophy (n = 1) [22].…”

Section: In Inherited Retinal Disordersmentioning

confidence: 99%

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Iovino

Pellegrini

Bernabei

et al. 2020

JCM

157

128

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Remarkable improvements in optical coherence tomography (OCT) technology have resulted in highly sophisticated, noninvasive machines allowing detailed and advanced morphological evaluation of all retinal and choroidal layers. Postproduction semiautomated imaging analysis with dedicated public-domain software allows precise quantitative analysis of binarized OCT images. In this regard, the choroidal vascularity index (CVI) is emerging as a new imaging tool for the measurement and analysis of the choroidal vascular system by quantifying both luminal and stromal choroidal components. Numerous reports have been published so far regarding CVI and its potential applications in healthy eyes as well as in the evaluation and management of several chorioretinal diseases. Current literature suggests that CVI has a lesser variability and is influenced by fewer physiologic factors as compared to choroidal thickness. It can be considered a relatively stable parameter for evaluating the changes in the choroidal vasculature. In this review, the principles and the applications of this advanced imaging modality for studying and understanding the contributing role of choroid in retinal and optic nerve diseases are discussed. Potential advances that may allow the widespread adoption of this tool in the routine clinical practice are also presented.

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“…The CVI, a ratio of LCA over TCA, has been applied to various chorioretinal diseases [10,20,21], including many inherited retinal dystrophies [12,22]. Wei et al found a decreased CVI in patients with RP, cone-rod dystrophy, Stargardt disease, Bietti crystalline dystrophym, and Best disease [22]. Recently, Iovino et al investigated the choroidal features associated with the presence of CME in eyes with RP, reporting an increased CT and decreased CVI in eyes with intraretinal fluid [12].…”

Section: Discussionmentioning

confidence: 99%

Choroidal Vascularity Features in Patients with Choroideremia and Cystoid Spaces

et al. 2021

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Cystoid spaces (CSs) are a common retinal finding in choroideremia (CHM) patients. The aim of this study was to analyze the vascular features of the choroid associated with the presence of CSs in patients with confirmed genetic diagnosis of CHM. A total of 33 patients (33 eyes) were enrolled in this retrospective cross-sectional study and divided into two groups based on the presence (17 eyes) or absence (16 eyes) of CSs. Choroidal features were evaluated on spectral-domain optical coherence tomography including subfoveal choroidal thickness (CT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA). The choroidal vascularity index (CVI) was then calculated in all study eyes. All structural choroidal parameters were calculated both on the entire length of the B-scan and in the central subfoveal 1500 μm. The average age was 37.3 ± 11.6 and 31.4 ± 16.7 years (p = 0.25) and mean logMAR best-corrected visual acuity was 0.11 ± 0.20 and 0.20 ± 0.57 (p = 0.54) in the CHM groups with and without CSs, respectively. There were no significant differences in subfoveal CT, and TCA, LCA, SCA, and CVI evaluated on either the entire scan or in the central 1500 μm (all p > 0.05). All choroidal vasculature parameters exhibited no significant differences between CHM eyes with and without CSs. Our results suggest that the choroid may not be involved in the development of CSs in patients with CHM.

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Choroidal structural analysis and vascularity index in retinal dystrophies

Abstract: Decreased choroidal vascularity was seen in eyes with retinal dystrophies. (CVI) may be a helpful tool in monitoring choroidal involvement in retinal dystrophies.

Cited by 29 publications

References 43 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

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Choroidal Vascularity Features in Patients with Choroideremia and Cystoid Spaces

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