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Optical coherence tomography angiography for visualization of retinal capillary plexuses in pachychoroid neovasculopathy

  • Ceying Shen
    Correspondence
    Correspondence to Ceying Shen, MD, Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, 90 Zhengzhou Hanghai Middle Road, Zhengzhou 450000, China.
    Affiliations
    Department of Ophthalmology, Zhengzhou Second People Hospital, Zhengzhou, China

    Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou, China
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  • Jianling Zhang
    Affiliations
    Department of Ophthalmology, Zhengzhou Second People Hospital, Zhengzhou, China

    Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou, China
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  • Jun Tian
    Affiliations
    Department of Ophthalmology, Zhengzhou Second People Hospital, Zhengzhou, China

    Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou, China
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  • Yu Liu
    Affiliations
    Department of Ophthalmology, Zhengzhou Second People Hospital, Zhengzhou, China

    Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou, China
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  • Hong Zhao
    Affiliations
    Department of Ophthalmology, Zhengzhou Second People Hospital, Zhengzhou, China

    Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou, China
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Published:October 14, 2020DOI:https://doi.org/10.1016/j.jcjo.2020.09.016

      Abstract

      Objective

      To evaluate retinal capillary plexus alterations in patients with pachychoroid neovasculopathy (PNV) by optical coherence tomographic angiography (OCTA).

      Design

      Retrospective observational study.

      Participants

      The study included 43 patients with PNV (43 eyes, PNV group) and 43 normal eyes (control group).

      Methods

      All PNV participants underwent comprehensive ophthalmic examinations, including OCTA. The results were compared with those of the controls. Differences in superficial and deep vascular density between the groups were analyzed. The correlations between vascular density and subfoveal choroidal thickness (SFCT), age, best-corrected visual acuity, refraction, and axial length were analyzed.

      Results

      The superficial vascular density of the macular region (except for the area of the fovea and the inferior parafoveal region) was significantly lower in the PNV group than the control group (p < 0.05). The deep vascular density of the macular region was significantly lower in the PNV group (p < 0.05). In the PNV group, there was no significant correlation between vascular density and SFCT, age, BVCA, refraction, or axial length (p > 0.05).

      Conclusions

      Superficial and deep vascular densities of the macular region were lower in the patients with PNV compared with the patients in the control group. In the patients with PNV, the macular region showed signs of inner retinal capillary dropout, which may be caused by choroidal ischemia and/or a chronic impairment of nutrient supply to the retinal pigment epithelium.

      Résumé

      Objectif

      Évaluer les modifications des plexus capillaires rétiniens en présence de néovasculopathie liée à la pachychoroïde (PNV, pour pachychoroid neovasculopathy) grâce à l'angiographie-tomographie par cohérence optique (OCT-A, pour optical coherence tomography angiography).

      Nature

      Étude d'observation rétrospective.

      Participants

      L’étude regroupait 43 patients, dont 43 yeux présentaient une PNV (groupe PNV) et 43 yeux étaient sains (groupe témoin).

      Méthodes

      Tous les sujets qui présentaient une PNV ont subi un examen ophthalmique complet, y compris une OCT-A. Leurs résultats ont été comparés à ceux du groupe témoin. On a alors analysé les différences quant à la densité vasculaire superficielle et profonde entre les 2 groupes. Les corrélations entre la densité vasculaire et l’épaisseur de la choroïde sous-fovéale (ECSF), l’âge, la meilleure acuité visuelle corrigée (MAVC), la réfraction et la longueur axiale ont également été analysées.

      Résultats

      La densité vasculaire superficielle de la région maculaire (sauf dans le cas de la fovéa et de la région parafovéale inférieure) était significativement moindre dans le groupe PNV que dans le groupe témoin (p < 0,05). La densité vasculaire profonde de la région maculaire était significativement inférieure dans le groupe PNV (p < 0,05). Toujours dans ce groupe, on n'a noté aucune corrélation significative entre la densité vasculaire et l'ECSF, l’âge, la MAVC, la réfraction, ni la longueur axiale (p > 0,05).

      Conclusions

      La densité vasculaire superficielle et profonde de la région maculaire était moindre chez les patients qui présentaient une PNV, comparativement aux patients du groupe témoin. Dans le groupe PNV, la région maculaire montrait des signes d'une non-perfusion capillaire dans la rétine interne, qui pourrait découler d'une ischémie choroïdienne ou d'une déficience chronique de l'apport d’éléments nutritifs vers l’épithélium pigmentaire rétinien.
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