Choroidal Structural Changes in Myopic Choroidal Neovascularization After Treatment With Antivascular Endothelial Growth Factor Over 1 Year

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Peripapillary Choroidal Vascularity Index in Glaucoma—A Comparison Between Spectral-Domain OCT and OCT Angiography

Park

Suh

Agrawal

et al. 2018

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“…20 In eyes from diabetic patients and eyes with exudative AMD, there were decreased CVI with no significant change in CT. 26,28,29 CVI was also shown to provide additional information to CT in terms of longitudinal choroidal structural changes in diseases such as panuveitis 20 ; Vogt-Koyanagi-Harada (VKH) disease 25 ; central serous chorioretinopathy (CSCR) 24 ; and myopic choroidal neovascularization. 27 Changes in L/C ratio or a similar index called L/S ratio (ratio of choroidal luminal area to stromal area) were investigated and found to yield valuable information in normal physiologic conditions including diurnal variation 22 and dynamic exercise 23 as well as in a number of ocular diseases including exudative AMD 21 ; polypoidal choroidal vasculopathy (PCV) 34 ; CSCR 32,33 ; VKH disease 30,31 ; and retinitis pigmentosa. 36 In this study, we compared the agreement between markers of choroidal vascularity (CVI and L/C ratio) measured by twoimage binarization techniques and significant differences were found between the two measurements.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Choroidal Vascularity Markers on Optical Coherence Tomography Using Two-Image Binarization Techniques

Wei

Sonoda

Mishra

et al. 2018

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METHODS. Spectral-domain OCT using enhanced-depth imaging was performed in 100 eyes from 52 normal subjects. Choroidal images were binarized to luminal area and stromal area using two different algorithms. Choroidal vascularity marker was defined as the ratio of luminal area to total choroidal area and they were termed ''luminal/choroidal area ratio (L/C ratio)'' and ''choroidal vascularity index (CVI)'' per the algorithm. The agreement between choroidal vascularity markers measured by the two techniques was compared using intraclass correlation coefficient (ICC) and Bland-Altman analysis. RESULTS.The mean values of choroidal vascularity markers were 70.12% (range, 56.76%-78.55%) for CVI and 67.44% (range, 51.09%-81.31%) for L/C ratio. Low level of absolute agreement between the two binarization techniques was reflected by an adjusted ICC of 0.353 using linear mixed model with age, sex, and spherical equivalent as covariates.CONCLUSIONS. There was discrepancy between measurements of choroidal vascularity using two commonly adopted image binarization techniques. It remained unclear what was the true choroidal vascularity and which binarization algorithm was more accurate. Future studies with enhanced image quality and improved image analysis algorithm are required to decipher the ground truth for choroidal vascularity.

“…Therefore, it may not truly reflect the functional aspect of choroidal blood flow. Novel imaging techniques such as OCT angiography and other biomarkers of choroidal vascularity, such as the choroidal vascularity index (CVI), 31,32 may further clarify the role of choroidal blood flow in MMD pathogenesis. Lastly, due to the cross-sectional design, causality cannot be inferred.…”

Section: Discussionmentioning

confidence: 99%

Is Choroidal or Scleral Thickness Related to Myopic Macular Degeneration?

Wong

Phua

Lee

et al. 2017

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Citation: Wong CW, Phua V, Lee SY, Wong TY, Cheung CMG. Is choroidal or scleral thickness related to myopic macular degeneration? Invest Ophthalmol Vis Sci. 2017;58:907-913. DOI:10.1167/iovs.16-20742 PURPOSE. The relative contribution of mechanical and vascular factors to the pathogenesis of myopic macular degeneration (MMD) is unclear. To address this gap, we examined the association of choroidal thickness (CT) and scleral thickness (ST) with MMD.METHODS. Prospective, clinic-based case series of 62 eyes of 41 patients with high myopia ( À6 diopters or axial length ‡26.5 mm). Swept-source optical coherence tomography (SSOCT) was performed to measure subfoveal CT and ST. Myopic macular degeneration was graded from fundus photographs according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification. Presence of MMD was defined as META-PM category ‡ 2 and severe MMD was defined as category ‡ 3.RESULTS. The distribution of MMD severity was 15 (24.2%) in category 1, 28 (45.2%) in category 2, 10 (16.1%) in category 3, and 9 (14.5%) in category 4. Correlation of MMD severity was strong for subfoveal CT (r ¼ À0.70, P < 0.001) but weak for subfoveal ST (r ¼ À0.31, P ¼ 0.01). Subfoveal CT, but not ST, was independently associated with presence of MMD (age and gender adjusted odds ratio [OR] per 10 lm decrease in CT 1.41, P ¼ 0.002), and subfoveal CT, but not subfoveal ST, was significantly thinner in eyes with severe MMD ( ‡ category 3) than in eyes with mild MMD (CT: 31.5 6 40.5 lm versus 82.0 6 57.1 lm, P < 0.001; ST: 261.6 6 78.5 lm versus 297.0 6 73.8 lm, P ¼ 0.09). CONCLUSIONS.We demonstrated significant thinning of the choroid with increasing MMD severity. In contrast, ST was weakly correlated with MMD. These data suggest progressive loss of choroid may be important in the pathogenesis of MMD.