Textural Properties of Choriocapillaris on OCTA in Healed Inflammatory Choriocapillaropathies

Abstract

BACKGROUND AND OBJECTIVE: To evaluate the flow characteristics and textural properties of choriocapillaris (CC) on optical coherence tomography angiography in eyes with resolved inflammatory choriocapillaropathies and Vogt-Koyanagi-Harada (VKH) disease. PATIENTS AND METHODS: A cohort of eyes with healed acute posterior multifocal placoid pigment epitheliopathy (APMPPE), serpiginous choroiditis (SC), and VKH disease were included. A 3 mm × 3 mm OCT angiogram of CC was acquired and graded for flow characteristics and textural properties. RESULTS: This study included 16 patients. Texture was heterogeneous in all eyes in the SC and VKH groups, and in four eyes (40%) in the APMPPE group. Most of the eyes with VKH disease had severe low flow, whereas most of the SC and APMPPE eyes demonstrated mild low flow. Heal duration had a strong negative correlation with severity of CC low flow and a weak, statistically nonsignificant correlation with texture heterogeneity. CONCLUSION: Despite the resolution of active inflammation, partial CC hypoperfusion and texture disruptions persist for longer durations and may resolve in a time dependent manner. [ Ophthalmic Surg Lasers Imaging Retina . 2019;50:566–572.]

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

“…In our study, VKH disease patients demonstrated increased CC-FV and FV average size during the acute phase but not the convalescent phase, consistent with previous studies reporting that systemic corticosteroids can mitigate FV ( 17 , 22 , 24 , 40 ). Indeed, the CC-FV observed in convalescent-stage VKH disease patients did not differ significantly from those measured in HCs.…”

“…Further, the CC-FV area fraction and CC-VPD correlated strongly with logMAR BCVA during the convalescent phase. The CC-VPD was also dramatically reduced during the acute stage but fully restored during the convalescent phase, in contrast to several previous reports (21)(22)(23)44). We speculate that this reflects effective recovery of CC blood flow after appropriate treatment.…”

“…Optical coherence tomography angiography (OCTA) permits non-invasive, detailed, and depth-resolved imaging of the chorioretinal microvasculature in disease states such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and uveitis (9)(10)(11)(12)(13)(14)(15). In addition, several OCTA studies have documented changes in the chorioretinal microvasculature associated with VKH disease (16)(17)(18)(19)(20)(21)(22)(23)(24). However, traditional OCTA images provide a limited field-of-view, necessitating montage imaging.…”

Mapping of choriocapillaris vascular density in young and aged healthy subjects

“…It has been found that CC plays a major role in different retinal pathologies such as age-related macular degeneration, 4,5 systemic hypertension,6 myopic maculopathy, 7 macular telangiectasia type 2, 8 retinal dystrophies, 9 or inflammatory choriocapillaropathies. 10 Choroidal vascularization remains difficult to measure due to light scattering when passing through the overlaying tissues and the retinal pigmentary epithelium (RPE). However, vascular density (VD), flow void areas and the choroidal vascular index (CVI) have been used.…”