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NEW INSIGHT INTO THE MACULAR DEEP VASCULAR PLEXUS IMAGED BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Bonnin, Sophie MD*; Mané, Valérie MD*; Couturier, Aude MD*; Julien, Morgane OA*; Paques, Michel MD, PhD; Tadayoni, Ramin MD, PhD*; Gaudric, Alain MD*

doi: 10.1097/IAE.0000000000000839
Original Study
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Purpose: To describe the macular deep capillary plexus (DCP) in normal eyes using optical coherence tomography angiography.

Methods: Retrospective study including 41 consecutive normal eyes imaged using optical coherence tomography angiography (RTVue XR Avanti; Optovue Inc). Default autosegmentation of the superficial capillary plexus (SCP) and DCP, and manual adjustments of “deep settings” were used to analyze the organization of the normal macular microvascularization and to investigate in vivo the connection between these capillary networks.

Results: Mean age was 31 years (range, 22–55 years). The SCP and DCP had 2 different organizations, but the plexus autosegmentation was imperfect: In 68% of cases, the image of the SCP variably superimposed on the DCP, interfering with its analysis. The SCP was composed on average of 7 pairs of arterioles and venules obvious on each 3-mm × 3-mm optical coherence tomography angiography scanning area. The DCP was composed of a capillary vortex arrangement, whose centers were aligned along the course of the macular superficial venules.

Conclusion: The SCP and DCP had two different topographic organizations. The pattern of the capillary units converging into capillary vortexes highly suggests that they drain into the superficial venules. The different structural properties of the SCP and DCP could explain the differences in flow resistance and perfusion.

Optical coherence tomography angiography showed that the deep capillary plexus was organized into polygonal units that converged into capillary vortexes, aligned along the course of the macular superficial venules. This topographic arrangement highly suggests that the deep capillary vortexes drain into the superficial venules.

*Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7—Sorbonne Paris Cité, Paris, France; and

Clinical Investigation Center 1423, Centre Hospitalier National des Quinze-Vingts, Institut National de la Santé et de la Recherche Médicale & Université Pierre et Marie Curie-Paris, France.

Reprint requests: Alain Gaudric, MD, Department of Ophthalmology—Hôpital Lariboisière 2 rue Ambroise Paré 75010 Paris, France; e-mail: agaudric@gmail.com

None of the authors have any financial/conflicting interests to disclose.

Source of funding: The authors received an independent research grant for this trial from Novartis Pharma SAS. The funding organisation had no role in the design or conduct of this research. The authors thank Optovue for having made available us the use of the Optovue Avanti device.

© 2015 by Ophthalmic Communications Society, Inc.