Institutional members access full text with Ovid®

Share this article on:

INNER CHOROIDAL FLOW SIGNAL ATTENUATION IN PACHYCHOROID DISEASE: Optical Coherence Tomography Angiography

Gal-Or, Orly, MD*,†,‡; Dansingani, Kunal K., MD, MA, FRCOphth†,§,*,*; Sebrow, Dov, MD*,†,*,*; Dolz-Marco, Rosa, MD, PhD*,†; Freund, K. Bailey, MD*,†,**,††

doi: 10.1097/IAE.0000000000002051
Original Study: PDF Only

Purpose: To study zones of reduced inner choroidal flow signal, foci of reduced inner choroidal thickness, and pathologically dilated Haller layer vessels (pachyvessels) in eyes with pachychoroid disease using optical coherence tomography (OCT) and OCT angiography.

Methods: Patients with treatment-naive pachychoroid disease were recruited. All patients prospectively underwent swept-source OCT and OCT angiography. Zones of reduced choriocapillaris flow were labeled and enumerated. Areas where reduced flow signal was attributable to masking/artifacts were excluded. Regions of inner choroidal thinning were identified on structural OCT and labeled. Overlap between reduced choriocapillaris flow and structural inner choroidal attenuation was quantified using Jaccard indices. The relationship of reduced flow to pachyvessels was recorded.

Results: Twenty-four eyes of 19 patients were identified. All eyes exhibited at least one zone of reduced flow. A total of 146 flow signal attenuation zones were identified. Sixty-two (42%) of 146 zones showed overlap or proximity with structural inner choroidal thinning. The mean Jaccard index per eye was 0.10 (SD = 0.08). Pachyvessels were spatially related to 100 (68%) of 146 zones of flow attenuation.

Conclusion: Zones of reduced choriocapillaris flow are prevalent in eyes with pachychoroid disease. Approximately 60% of these zones anatomically correlate with pachyvessels. Inner choroidal ischemia seems related to the pathogenesis of pachychoroid diseases.

This study evaluated zones with reduced inner choroidal flow signal, foci of reduced inner choroidal thickness, and pathologically dilated Haller layer vessels (pachyvessels) in pachychoroid disease eyes using optical coherence tomography and optical coherence tomography angiography. These zones of reduced inner choroidal flow were found to be anatomically correlated with pachyvessels.

*Vitreous Retina Macula Consultants of New York, New York, New York;

LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; Department of Ophthalmology,

Rabin Medical Center, Petah Tikva, Israel;

§University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;

**Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York; and

††Department of Ophthalmology, New York University School of Medicine, New York, New York.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, New York, NY 10022; e-mail: kbfnyf@aol.com

Supported by the LuEsther T. Mertz Retinal Research Center and the Macula Foundation Inc, New York, NY. The funding bodies had no role in the design or execution of this study or the decision to publish.

R. Dolz-Marco is supported by research grants from Alcon, Allergan, Bayer, Genentech, Heidelberg Engineering, Novartis, and Thea. K. B. Freund is a consultant for Optovue, Optos, Heidelberg Engineering, Genentech, and Spark Therapeutics. He receives research support from Genentech/Roche. The remaining authors have no conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.