Choroid vascular changes in hyperopic anisometropia amblyopia using SS-OCTA.

PURPOSE: To observe and understand the structural changes in choroidal vessels in eyes with hyperopic anisometropic amblyopia using swept-source optical coherence tomography angiography (SS-OCTA). METHODS: A total of 44 patients were enrolled in this study: 22 children with hyperopic anisometropic amblyopia and 22 age-matched controls. SS-OCTA was used to scan the 6*6 mm macular area of their eyes. The average choroidal thickness (CT) and choroidal capillary flow area (CC) in a 3 mm diameter area centered on the macular area were obtained. The choroidal vascularity volume (CVV) was automatically extracted and 3D reconstructed by inbuild software, and the three-dimensional choroidal vascularity index (3D-CVI) was calculated. The effect of amblyopia on the choroidal vessel structure was assessed using generalized linear estimating equations (GEEs) corrected for axial length, sex, age, and best-corrected visual acuity. RESULTS: The CC was greater in amblyopic eyes than in fellow eyes (P = 0.014) but was not significantly different from that in control eyes (P = 0.963). After correcting for sex, age, axial length, and visual acuity using GEEs, the mean CT in the amblyopic eyes was greater than that in the fellow eyes (P = 0.030) but was not significantly different from that in the control eyes (P = 0.160). The 3D-CVI in amblyopic eyes was higher than that in control eyes (P = 0.038) but was not significantly different from that in fellow eyes (P = 0.407). The three-dimensional choroidal vascularity volume (3D-CVV) was higher in amblyopic eyes than in fellow eyes (P = 0.046) and control eyes (P = 0.023). CONCLUSIONS: We found that eyes with hyperopic anisometropic amblyopia demonstrated higher CT, CC and 3D-CVV values than the contralateral eyes after correction, while the 3D-CVI was unchanged. Compared with control eyes, amblyopic eyes had higher 3D-CVV and 3D-CVI values but similar CT and CC values. Amblyopic eyes may have different choroidal vascular structures from fellow and control eyes.

Insights into the underlying choroid in different stages of idiopathic epiretinal membranes after Viteromacular surgery.

PURPOSE: The purpose of the study was to longitudinally investigate the correlation between choroidal morphologic and vascular parameters and postoperative visual outcome in different stages of idiopathic epiretinal membranes (iERMs). METHODS: A prospective, observational, institutional case series of 102 consecutive patients diagnosed with unilateral iERMs were recruited at Peking University Third Hospital and were followed up for 12 months after surgical treatment with vitrectomy. Participants were classified into four stages according to current staging scheme. All eligible subjects underwent standardized imaging evaluation of choroidal parameters including subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), and choroidal capillary perfusion (CCP) at baseline and each follow-up by enhanced depth optical coherence tomography (EDI-OCT) and OCT angiography (OCTA). Longitudinal follow-up of choroidal parameters over 12 months was analysed, and their correlations with best-corrected visual acuity (BCVA) were also assessed for predictive prognostic value. RESULTS: CVI and CCP were significantly correlated with BCVA at each follow-up examination (all p < 0.05). However, SFCT exhibited no variation among different stages of iERMs at baseline (p = 0.981) or during follow-up (p = 0.520). The preoperative CVI correlated with 12-month postoperative BCVA (p < 0.001) and its predictive prognostic effect on BCVA was validated in multiple regression analysis (p = 0.006). CONCLUSION: CVI varied among different stages of iERM and was significantly correlated with visual outcomes after the surgery. CVI could serve as a predictive prognostic marker in iERMs, which further indicates the underlying choroid should be taken into consideration in clinical evaluation of iERMs.

Optical coherence tomography angiography of central serous chorioretinopathy: quantitative evaluation of the vascular pattern and capillary flow density.

BACKGROUND: This study aimed to evaluate the vascular pattern and capillary flow density (CFD) map on optical coherence tomography angiography (OCTA) images of patients affected by central serous chorioretinopathy (CSC). METHODS: In this retrospective cohort study, OCTA (AngioVue RTVue XR Avanti, Optovue) 3 × 3 mm macula scans of both eyes of patients with CSC were taken at baseline; the images were segmented and compared with OCTA scans of fellow eyes without CSC as well as age-matched healthy subjects. OCTA images were processed by quantitative textural analysis (ImageJ software) to provide an objective grading of choroidal capillary alterations. The texture of OCTA images was examined by the autocorrelation method. RESULTS: In eyes with CSC (40 eyes), we found six different morphological patterns of the choriocapillaris layer vasculature (CCL), likely corresponding to different grades of OCT choroidal hyporeflectivity and OCTA reduction of the decorrelation signal. Moreover, the OCTA capillary flow density map revealed capillary depletion in the superficial capillary plexus (p value = 0.0023), in the deep vascular network (p value = < 0.0001), and in the CCL (p value = 0.0001). Such findings were not observed in healthy subjects (13 eyes). CONCLUSIONS: OCTA in CSC is a useful tool that allows the identification of the clinical type of CSC by means of specific CCL patterns. Moreover, CFD depletion is observed in association with the inner retinal layers, pointing to an involvement of the inner blood retinal barrier in CSC. According to our results, it is plausible that the patterns observed herein may correlate to the different clinical subtypes of the disease.

Choroidal morphologic and vascular features in patients with unilateral idiopathic epiretinal membranes: An optical coherence tomography analysis integrated with assessment of retinal layers.

Introduction: Integrated analysis of retinal and choroidal morphologic and vascular features is urgently needed to examine whether and how these two elements interact with each other, thus contributing to visual impairment in patients with idiopathic epiretinal membranes (iERMs). Methods: An observational retrospective study consisting of 181 patients diagnosed with unilateral iERM between August 2019 and July 2022 was carried out at Peking University Third Hospital. All patients underwent a standardized set of ophthalmologic examinations, including EDI-OCT and OCTA scanning, and were subsequently categorized into four stages according to current classification schemes based on their OCT findings. Altogether, 15 qualitative and quantitative parameters of both the retina (full-layer, inner and outer layers) and choroid were identified. Results: The results revealed variations in the choroidal vascularity index (CVI) among different stages of iERMs (p < 0.001) for the first time. Distributions of retinal parameters across four stages of iERMs were validated. Correlation analysis between choroidal and retinal parameters showed that the CVI was associated with both inner and outer retinal morphologic biomarkers. Functional damage to retinal integrity was determined to be a strong contributor to visual acuity reduction in iERMs. Discussion: This study complemented our present understanding of posterior segment structural and vascular alterations in iERMs.

Analysis of Retinochoroidal Vasculature in Underweight Women Using Optical Coherence Tomography Angiography.

Introduction Being underweight (body-mass index < 18.50 kg/m2) is associated with significantly higher morbidity than having normal weight. We aimed to investigate the changes in choroid and retinal capillary microcirculation with optical coherence tomography angiography in underweight female subjects compared with an age- and sex-matched population of healthy subjects. Methods This prospective, cross-sectional study included 48 eyes of 48 healthy female subjects, of whom 23 were underweight and 25 had normal weight. Optical coherence tomography angiography was used for the evaluation of retinal vessel density, foveal avascular zone, subfoveal central macular thickness, subfoveal choroidal thickness, and choriocapillaris flow area. Results The mean choriocapillaris flow area was statistically significantly higher in the underweight group (2.201 ± 0.11 mm2) compared to the control group (2.111 ± 0.11 mm2) (p=0.005). The subfoveal choroidal thickness was higher in the underweight group (340 ± 61.2 µm) compared to the control group (317 ± 20.8 µm) but the difference was not statistically significant (p=0.099). Similarly, no statistically significant difference was determined between the groups concerning the vessel density, subfoveal central macular thickness, and foveal avascular zone. Conclusions Being underweight is associated with a higher subfoveal choroidal thickness and choriocapillaris flow area, independent of additional factors, such as age, axial length, intraocular pressure, and major ocular diseases.

Correlation between Visual Acuity and Optical Coherence Tomography Angiography Parameters in Unilateral Idiopathic Epiretinal Membrane.

BACKGROUND: The tangential traction by idiopathic epiretinal membrane (iERM) may alter the hemodynamics of the macula. We investigated the correlation between visual acuity and the optical coherence tomography angiography (OCTA) parameters in unilateral iERM. METHODS: We included 61 eyes of 61 consecutive patients with unilateral iERM between January 2018 and December 2018. The flow area of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choroidal capillary plexus (CCP) were measured using OCTA. The normal fellow eyes were used for comparison. The iERM patients were divided into those with a presence of foveal concavity and those with a loss of foveal concavity. RESULTS: When compared with fellow eyes, the flow areas showed a statistically significant decrease in the SCP and CCP of those with iERM (p = 0.037 and p = 0.011, respectively). In the DCP, no significant reduction in flow area was found in iERM (p = 0.054). The flow area of the CCP was the only factor significantly associated with best vision (p = 0.012). No significant differences in the flow areas of the SCP, DCP, and CCP were found between the presence and loss of foveal concavity. CONCLUSIONS: The flow area of the CCP is an important determinant of vision, emphasizing the crucial role of choroidal circulation in iERM. Moreover, mechanical stretch by iERM is not the only mechanism affecting the flow area.

Preliminary observation of choroidal capillary flow area and density in patients with idiopathic macular hole before and after surgery / 中华眼底病杂志

Objective@#To observe the changes of choroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.@*Methods@#A prospective clinical study. Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex- matched normal controls were included in this study. All eyes were divided into group A (30 affected eyes), group B (30 fellow eyes) and group C (30 normal eyes of controls). Among 30 eyes in group A, there were 5, 14, 11 eyes with hole in stage Ⅱ, Ⅲ, Ⅳ, respecitvely. The eyes in group A were divided into two subgroups according to the diameter of the holes: group D: hole diameter less than or equal to 500 μm (11 eyes), group E: hole diameter over than 500 μm (19 eyes). All eyes in group A underwent vitrectomy. Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A. The CBFA and blood flow density of superficial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A, B and C. Univariate analysis of variance and t test were used for statistical analysis.@*Results@#Before surgery, in group A, B and C, the CBFA were 2.84±0.35, 3.19±0.23, 3.26±0.24 mm2, the blood flow density were (20.74±8.26)%, (35.18±5.20)%, (35.20±6.49)%, respectively. The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768, 45.583; P = 0.000, 0.000), but there was no significant difference between group B and C (F=19.768, 45.583; P=0.332, 0.994). The CBFA and blood flow density in group D were higher than those in group E (t=2.230, 2.202; P=0.034, 0.036). The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377, -0.477; P=0.044, 0.009). Three months after surgery, the macular holes in group A were closed; CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126, -4.912; P=0.000, 0.000).@*Conclusions@#CBFA and blood flow density decreased in the macular area of IMH. CBFA and blood flow density can be recovered after vitrectomy.

Preliminary observation of choroidal capillary flow area and density in patients with idiopathic macular hole before and after surgery / 中华眼底病杂志

Objective To observe the changes ofchoroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.Methods A prospective clinical study.Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex-matched normal controls were included in this study.All eyes were divided into group A (30 affected eyes),group B (30 fellow eyes) and group C (30 normal eyes of controls).Among 30 eyes in group A,there were 5,14,11 eyes with hole in stage Ⅱ,Ⅲ,Ⅳ,respecitvely.The eyes in group A were divided into two subgroups according to the diameter of the holes:group D:hole diameter less than or equal to 500 μm (11 eyes),group E:hole diameter over than 500 μm (19 eyes).All eyes in group A underwent vitrectomy.Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A.The CBFA and blood flow density of superticial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A,B and C.Univariate analysis of variance and t test were used for statistical analysis.Results Before surgery,in group A,B and C,the CBFA were 2.84± 0.35,3.19± 0.23,3.26±0.24 mm2,the blood flow density were (20.74 ± 8.26)％,(35.18 ± 5.20)％,(35.20± 6.49)％,respectively.The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768,45.583;P =0.000,0.000),but there was no significant difference between group B and C (F=19.768,45.583;P=0.332,0.994).The CBFA and blood flow density in group D were higher than those in group E (t=2.230,2.202;P=0.034,0.036).The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377,-0.477;P=0.044,0.009).Three months after surgery,the macular holes in group A were closed;CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126,-4.912;P=0.000,0.000).Conclusions CBFA and blood flow density decreased in the macular area ofIMH.CBFA and blood flow density can be recovered after vitrectomy.