Pulsation of anastomotic vortex veins in pachychoroid spectrum diseases.
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ABSTRACT:
SUBMITTER: Matsumoto H
PROVIDER: S-EPMC8298457 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeTo compare the distribution of vortex vein ampulla (VVA) between pachychoroid spectrum disorder (PSD) and controls.DesignA single-center, case-control study.ParticipantsThis study included 75 PSD, 35 fellow, and 65 control eyes.MethodsWe quantified VVA distribution using a 3-dimensional reverse projection model corrected for image distortion. We investigated the distribution of major drainage veins (MDV), in which macular Haller's vessels directly influx.Main outcome measuresThe mean distances from the optic disc to VVAs and the mean angles between VVAs and the fovea-disc line.ResultsThe PSD group had significantly fewer VVA in infranasal sector (PSD, fellow, control; 1.6 ± 0.6, 1.8 ± 0.6, 1.9 ± 0.6, respectively, P = 0.026). In supralateral sector, for PSD, fellows, and controls, the mean distances from the optic disc to VVAs were 14.1 ± 1.0 mm, 14.1 ± 1.1 mm, and 13.6 ± 1.4 mm, respectively, and were significantly farther in PSD than in controls (P = 0.023). The mean angles between VVAs and the fovea-disc line were 64.8 ± 5.9°, 66.4 ± 6.4°, and 61.7 ± 6.4°, respectively, and were significantly higher in PSD and fellows than in controls (P = 0.008). The mean distances from the optic disc to MDV in supratemporal sector were 14.1 ± 1.2 and 13.7 ± 1.2 in eyes whose Haller's vessels extended beyond the fovea-disc line (asymmetry), and those that did not, respectively, with the asymmetric eyes significantly farther (P = 0.016).ConclusionsThe VVA position in supralateral sector was farther and higher in PSD than in controls, suggesting that the distribution of VVA may be associated with the development of PSD.Financial disclosuresProprietary or commercial disclosure may be found after the references.
| S-EPMC10238580 | biostudies-literature
Project description:Choroidal changes have been suggested to be involved in the pathophysiology of both age-related macular degeneration (AMD) and pachychoroid spectrum diseases (PSD). To find out the choroidal characteristics of each disease groups, various groups of AMD and PSD were classified into several clusters according to choroidal profiles based on subfoveal choroidal thickness (CT), peripapillary CT, the ratio of subfoveal CT to peripapillary CT and age. We retrospectively analyzed 661 eyes, including 190 normal controls and 471 with AMD or PSDs. In the AMD groups, eyes with soft drusen or reticular pseudodrusen were belonged to the same cluster as those with classic exudative AMD (all p < 0.001). However, eyes with pachydrusen were not clustered with eyes from other AMD groups; instead, they were classified in the same cluster as eyes from the PSD group (all p < 0.001). In the PSD group, eyes with pachychoroid neovasculopathy were grouped in the same cluster of those with polypoidal choroidal vasculopathy (p < 0.001). The cluster analysis based on the CT profiles, including subfoveal CT, peripapillary CT, and their ratio, revealed a clustering pattern of eyes with AMD and PSDs. These findings support the suggestion that pachydrusen has the common pathogenesis as PSD.
| S-EPMC7925534 | biostudies-literature
Project description:PurposeThe purpose of this article is to report serous macular detachment (SMD) similar to that seen in central serous chorioretinopathy (CSCR) in patients with nanophthalmos.ObservationIt is a retrospective case series from a tertiary eye care center in India. Multi modal imaging features of eyes with serous macular detachment in patients with nanophthalmos including colour fundus photographs, short wave autofluorescence, fundus fluorescein angiography and optical coherence tomography were studied. In addition axial length, anterior chamber depth, lens thickness and subfoveal choroidal thickness were measured. The eyes were treated with laser photocoagulation to the focal leak seen on fluorescein angiography. The patients were followed up for 12-18 months.ResultsThree eyes of three patients having serous macular detachment in nanophthalmos were identified. All three eyes had axial length <21mm, subfoveal choroidal thickness >450 microns and a focal leak on fluorescein angiography. Two eyes had serous pigment epithelial detachments underneath the SMD as well. Two eyes had peripheral pigmentary changes due to resolved subretinal fluid. The SMD resolved completely in two eyes and partially in one eye following focal laser photocoagulation.Conclusion and importanceSerous macular detachments bearing features similar to that of CSCR can occur in the setting of nanophthalmos. These may represent manifestation of thick choroid or may represent forme fruste choroidal effusion.
| S-EPMC6661461 | biostudies-literature
Project description:This study was conducted to examine retinal sensitivity (RS) in eyes with pachychoroid diseases and to analyze its association with the presence or absence of quiescent choroidal neovascularization (CNV), that can be protective against retinal dysfunction or atrophy in other macular diseases such as age-related macular degeneration. A total of 12 eyes of 12 patients aged ≥45 years having the characteristic findings of central serous chorioretinopathy but not presenting any exudative changes were included in this study. Choroidal vascular hyper permeability (CVH) was identified by indocyanine green angiography, and the presence or absence of CNV was evaluated by optical coherence tomography angiography. RS at 68 points was examined by microperimetry. The average RS corresponding to within and outside CVH was compared. The association between the difference in RS and the presence or absence of CNV was also analyzed. CNV was detected in six eyes (50%). In eyes without CNV, the RS within CVH was similar compared with that outside CVH. However, in eyes with CNV, the RS within CVH was significantly decreased compared with that outside CVH. Multiple regression analysis revealed the presence of CNV as an independent factor associated with RS. In eyes with pachychoroid diseases, RS decreased within the CVH area under the coexistence of nonexudative CNV.
| S-EPMC9321376 | biostudies-literature
Project description:The emergence of pachychoroid disease is changing the concept of age-related macular degeneration (AMD). The concept of pachychoroid diseases was developed through clinical observation of multimodal images of eyes with AMD and central serous chorioretinopathy; however, recent genetic studies have provided a proof of concept for pachychoroid spectrum disease, which should be differentiated from drusen-driven AMD. The genetic confirmation of pachychoroid concept further provides novel viewpoints to decode previously reported findings, which facilitates an understanding of the true nature of pachychoroid diseases and AMD. The purpose of this review was to elucidate the relationship between pachychoroid diseases and AMD by interpreting previous findings on pachychoroid diseases and AMD from the novel viewpoints of genetic associations. We confirmed that previous genetic studies supported the concept of pachychoroid diseases. From a genetic viewpoint, the presence of thick choroid and the presence of choroidal vascular hyperpermeability were important characteristics of pachychoroid spectrum diseases. Previous studies have also suggested the classification of polypoidal choroidal vasculopathy (PCV) into two subtypes, pachychoroid neovasculopathy and drusen-driven PCV. Genetic viewpoints will be beneficial to rearrange subtypes of drusen-driven AMD and pachychoroid spectrum diseases. Further genetic studies are needed to investigate pachyvessels, pachydrusen and the significance of polypoidal lesions in pachychoroid neovasculopathy and drusen-driven AMD/PCV.
| S-EPMC7409179 | biostudies-literature
Project description:PURPOSE:To investigate the correlation between geographic filling delays in the choriocapillaris using indocyanine green angiography (ICGA) images and dilated vortex veins in central serous chorioretinopathy (CSC). DESIGN:Observational case series. PARTICIPANTS:Thirty-two eyes of 32 patients, 21 with acute and 11 with chronic CSC. METHODS:Digital ICGA and fluorescein angiography (FA), with videoangiography, and swept-source optical coherence tomography (SS-OCT) for B-scan and en-face choroidal imaging were performed. Overlapping of the filling delay areas in the choriocapillaris in the early-phase ICGA images and the region of dilated vortex veins in the en-face images were analyzed. The consistency of both areas was graded as follows. Grade 3: filling delay area is entirely involved in the dilated vortex vein region. Grade 2: 50% or more of filling delay area overlaps with the dilated vortex vein region. Grade 1: less than 50% of filling delay area overlaps with the dilated vortex vein region. Grade 0: no tendency for overlapping of two areas. We evaluated the asymmetry of upper and lower vortex veins in en-face images of the Haller layer. Using the binarization method, we quantified the luminal and stromal areas of the choroid. The ratios of the Haller layer area and luminal areas in the Haller layer to total choroidal area were examined. RESULTS:The consistency of overlapping of the two areas was grade 2.62 ± 0.49 in acute CSC and grade 1.55 ± 0.78 in chronic CSC (p = 0.0005). Asymmetry of upper and lower vortex veins was seen in 17 of 22 eyes (81%) with acute CSC and 6 of 11 eyes (54.5%) with chronic CSC (p = 0.114). Central choroidal thickness was 411 ± 79 ?m in acute CSC and 326 ± 64 ?m in chronic CSC (p = 0.004). In the posterior fundus with a 4500 ?m diameter, the ratio of the Haller layer area to total choroidal area was 63.7 ± 8.6% in acute CSC and 57.1 ± 7.9% in chronic CSC (p = 0.047). The ratio of the luminal area in the Haller layer area to total choroidal area was 46.9 ± 7.6% in acute CSC and 40.0 ± 6.9% in chronic CSC (p = 0.014). CONCLUSION:Filling delay areas in the choriocapillaris and dilated vortex vein regions showed marked overlapping in acute CSC. Increased choroidal thickness was attributed to dilated vortex veins. These findings suggest that the blood flow into the choriocapillaris is delayed as a result of congestion of the dominant vortex veins that supply this geographic area. CSC may be a disease characterized by vortex vein congestion that develops in eyes with asymmetric vortex veins.
| S-EPMC6226146 | biostudies-literature
Project description:Recently, several research groups have reported a newly recognized clinical entity of choroidal neovascularization, termed pachychoroid neovasculopathy. However, its characteristics have yet to be well described. The purpose of this study was to investigate the clinical and genetic characteristics of pachychoroid neovasculopathy regardless of treatment modality. This study included 99 eyes of 99 patients with treatment-naïve pachychoroid neovasculopathy. Mean initial best-corrected visual acuity (BCVA) was 0.20?±?0.32 logMAR, and did not change (P?=?0.725) during follow-up period (mean?±?SD, 37.0?±?17.6 months). Subretinal hemorrhage (SRH) (??4 disc areas in size) occurred in 20 eyes (20.2%) during follow-up. Age, initial BCVA, central retinal thickness, SRH (??4 disc areas in size) and treatment (aflibercept monotherapy) were significantly associated with the final BCVA (P?=?0.024,?<?0.001, 0.031,?<?0.001, and 0.029, respectively). Multiple regression analysis showed initial BCVA and presence of SRH to be significant predictors of final BCVA (both P?<?0.001). Polypoidal lesions were more common in the SRH group than in the non-SRH group (85.0% vs 48.1%, P?=?0.004). There was no significant difference in the frequency of the risk allele in ARMS2 A69S, CFH I62V, CFH Y402H between these groups (P?=?0.42, 0.77, and 0.85, respectively). SRH (29.1% vs 9.1%, P?=?0.014) and choroidal vascular hyperpermiability (65.5% vs 43.2%, P?=?0.027) were seen more frequently in the polypoidal lesion (+) group than in the polypoidal lesion (-) group. There was considerable variation in lesion size and visual function in patients with pachychoroid neovasculopathy, and initial BCVA and presence of SRH at the initial visit or during the follow-up period were significant predictors of final BCVA.
| S-EPMC7530669 | biostudies-literature
Project description:PURPOSE:To determine the comparability of choroidal thickness (ChT) measurements using swept source (SS) and spectral domain (SD) optical coherence tomography (OCT) devices in patients with pachychoroid diseases. METHODS:Patients with pachychoroid diseases were recruited. OCT scans were performed sequentially with a Cirrus HD OCT 5000 and Plex Elite 9000. Images were analyzed by two independent observers. Each image was independently measured twice by each observer to determine the intraobserver repeatability. RESULTS:A total of 55 eyes were included. The average ChT of the subfoveal area using SS-OCT and SD-OCT was 430.5 ± 68.1 and 428.5 ± 57.9 ?m, respectively, which did not show a significant result as the main effect in the repeated-measure analysis of variance (P = 0.067). Using SS-OCT, the intraobserver intraclass correlation coefficient (ICC) of both observers was > 0.950 at every measured point, and the interobserver coefficient of repeatability (CR) of the subfoveal area was 45.1 ?m (95% confidence interval (CI), 40.8-49.4). Using SD-OCT, the intraobserver ICC of both observers was > 0.800, and the interobserver CR of the subfoveal area was 71.2 ?m (95% CI, 64.4-78.0). Additionally, the intraobserver and interobserver CRs showed significantly better repeatability in SS-OCT than SD-OCT in F-test. In patients with ChT ? 400 ?m, the interobserver CRs of SS-OCT and SD-OCT were 48.4 (95% CI, 42.6-54.2) and 95.2 ?m (95% CI, 83.9-106.6), respectively. In patients with a subfoveal active lesion, the interobserver CRs were 44.5 (95% CI, 37.6-51.4) and 100.1 ?m (95% CI, 84.6-115.5), respectively. CONCLUSIONS:Although the ChT measurements were comparable between SS-OCT and SD-OCT devices in pachychoroid diseases, SD-OCT showed low reliability in patients with ChT ? 400 ?m and subfoveal active lesions. SS-OCT would be therefore more suitable for observation and follow-up of choroidal structures in pachychoroid diseases.
| S-EPMC7043756 | biostudies-literature
