scholarly journals Choriocapillaris impairment around the atrophic lesions in patients with geographic atrophy: a swept-source optical coherence tomography angiography study

2018 ◽  
Vol 103 (7) ◽  
pp. 911-917 ◽  
Author(s):  
Marco Nassisi ◽  
Yue Shi ◽  
Wenying Fan ◽  
Enrico Borrelli ◽  
Akihito Uji ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Signal Loss ◽  
Swept Source ◽  
Age Related ◽  
En Face ◽  
Wide Ring

AimsTo evaluate the choriocapillaris (CC) flow alterations around geographic atrophy (GA) in eyes with dry age-related macular degeneration.MethodsUsing a swept-source optical coherence tomography angiography (SS-OCTA) device, two volume 6×6 mm scans were acquired in patients with GA presenting between June and December 2017 at the Doheny-UCLA Eye Centers. The area of GA was delineated on the en face structural OCT fundus images. For each eye, the en face OCTA slabs at the level of the CC from the two acquisitions were averaged and compensated for signal loss using the corresponding structural en face images. The resulting images were binarised and analysed for the percentage of flow voids in the para-atrophy zone (a 500 µm wide ring around the immediate edge of the atrophy) and in the peri-atrophy zone (a 500 µm wide ring around the para-atrophy zone edge), the latter considered as a reference in the comparative analysis.ResultsThirty eyes of 20 patients were enrolled. The percentage of flow voids in the para-atrophy zone was 27.23%±6.29% and was significantly higher than in the surrounding peri-atrophy zone (23.4%±6.01%; p<0.001). There was no significant correlation between the flow void percentage in these regions and age, visual acuity, extent of the atrophic area or central choroidal thickness.ConclusionsA significant impairment of the CC flow is present in the zone immediately surrounding the GA lesions strengthening the hypothesis that CC alterations may be relevant to the progression of GA.

scholarly journals The Spectrum of Central Choriocapillaris Abnormalities on Swept-Source Optical Coherence Tomography Angiography in the Fellow Eye of Unilateral Exudative Age-Related Macular Degeneration Patients: From Flow Deficits to Subclinical Non-Exudative Neovascularization

2021 ◽  
Vol 10 (12) ◽  
pp. 2658
Author(s):  
Alexis Khorrami Kashi ◽  
Eric Souied ◽  
Selim Fares ◽  
Enrico Borrelli ◽  
Vittorio Capuano ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Optical Coherence Tomography Angiography ◽  
Clinical Findings ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Swept Source ◽  
Exudative Amd ◽  
Age Related ◽  
Fellow Eyes

We evaluated the spectrum of choriocapillaris (CC) abnormalities in the fellow eyes of unilateral exudative age-related macular degeneration (AMD) patients using swept-source optical coherence tomography angiography (SS-OCTA). Fellow eyes of unilateral exudative AMD patients were prospectively included between May 2018 and October 2018. Patients underwent a multimodal imaging including a SS-OCTA. Demographics and clinical findings were analyzed. The estimated prevalence of macular neovascularization (MNV) was computed. Number and size of flow deficits (FDs) and percentage of flow deficits (FD%) were computed on the compensated CC flow images with the Fiji software. We included 97 eyes of 97 patients (mean age was 80 ± 7.66 years, 39 males, 58 females). The prevalence of MNV in the studied eyes was 8.25% (8/97 eyes). In the 89 non-neovascular eyes, FD% averaged 45.84% ± 11.63%, with a corresponding total area of FDs of 4.19 ± 1.12 mm2. There was a higher prevalence of drusenoid pigment epithelial detachment in eyes with subclinical neovascularization (p = 0.021). Fellow eyes with unilateral exudative AMD encompassed a series of CC abnormalities, from FDs of the aging CC to subclinical non-exudative MNV.

scholarly journals Need for manual segmentation in optical coherence tomography angiography of neovascular age-related macular degeneration

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244828
Author(s):  
Supriya Dabir ◽  
Vaidehi Bhatt ◽  
Deepak Bhatt ◽  
Mohan Rajan ◽  
Preetam Samant ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Automated Segmentation ◽  
Optical Coherence ◽  
Manual Segmentation ◽  
Outer Retina ◽  
Age Related ◽  
En Face

Purpose To compare the characteristics of eyes that had manual vs. automated segmentation of choroidal neovascular membrane (CNVM) using optical coherence tomography angiography (OCTA). Methods All patients with CNVM underwent OCTA using the Zeiss Angioplex Cirrus 5000. Slabs of the avascular outer retina, outer retina to choriocapillaris (ORCC) region and choriocapillaris were generated. Manual segmentation was done when there were significant segmentation artifacts. Presence of activity of CNVM was adjudged by the presence of subretinal fluid (SRF) on structural OCT and was compared to activity detected on en face OCTA slabs based on well-defined criteria. Results Eighty-one eyes of 81 patients were recruited of which manual segmentation was required in 46 (57%). Eyes with automated segmentation had significantly more CNVM in the ORCC (75%) whereas those with manual segmentation had deeper CNVM (sub-RPE = 22%, intra-PED = 22%) (p<0.001). Twenty eyes (25%) were found to have active CNVM on both the structural OCT and OCTA while an additional 19 eyes were presumed to have active CNVM on OCTA alone. There was only modest concordance between disease activity detected using structural OCT and OCTA (Kappa = 0.47, 95% CI = 0.30 to 0.64). Conclusions Manual segmentation of OCTA is required in more than 50% eyes with CNVM and this progressively increases with increasing depth of CNVM location from the ORCC to below the RPE. There is moderate concordance between OCTA and structural OCT in determining CNVM activity.

scholarly journals Optical Coherence Tomography Angiography of the Choriocapillaris in Age-Related Macular Degeneration

2021 ◽  
Vol 10 (4) ◽  
pp. 751 ◽  
Author(s):  
Jackson Scharf ◽  
Giulia Corradetti ◽  
Federico Corvi ◽  
SriniVas Sadda ◽  
David Sarraf
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Modality ◽  
Careful Consideration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Age Related ◽  
Processing Techniques

The advent of optical coherence tomography angiography (OCTA) has allowed for remarkable advancements in our understanding of the role of the choriocapillaris in age-related macular degeneration (AMD). As a relatively new imaging modality, techniques to analyze and quantify choriocapillaris images are still evolving. Quantification of the choriocapillaris requires careful consideration of many factors, including the type of OCTA device, segmentation of the choriocapillaris slab, image processing techniques, and thresholding method. OCTA imaging shows that the choriocapillaris is impaired in intermediate non-neovascular AMD, and the severity of impairment may predict the advancement of disease. In advanced atrophic AMD, the choriocapillaris is severely impaired underneath the area of geographic atrophy, and the level of impairment surrounding the lesion predicts the rate of atrophy enlargement. Macular neovascularization can be readily identified and classified using OCTA, but it is still unclear if neovascularization features with OCTA can predict the lesion’s level of activity. The choriocapillaris surrounding macular neovascularization is impaired while the more peripheral choriocapillaris is spared, implying that choriocapillaris disruption may drive neovascularization growth. With continued innovation in OCTA image acquisition and analysis methods, advancement in clinical applications and pathophysiologic discoveries in AMD are set to follow.

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