Search

Purpose: The main aim was to identify different choroidal patterns in retinitis pigmentosa (RP) and to assess their clinical and anatomical meanings after 1 year of follow-up., Methods: Forty-five patients with RP (29 men; mean age 44.5 ± 11.7 years) and 45 healthy controls (29 men; mean age 44.2 ± 9.8 years) were recruited. Optical coherence tomography (OCT) and OCT angiography (OCTA) images were obtained. By means of structural OCT, the following three choroidal patterns were identified: normal-appearing choroid (pattern 1), reduced Haller and Sattler layers (pattern 2), and pattern 2 + choroidal caverns (pattern 3). Main outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), vessel density, vessel tortuosity, vessel dispersion, vessel rarefaction, and choroidal stromal index (CSI)., Results: Mean BCVA was 0.27 ± 0.30 LogMAR for patients with RP and 0.0 ± 0.0 LogMAR for controls ( P < 0.01). CMT, CT, CSI, and OCTA parameters were statistically different between patients with RP and controls ( P < 0.01). Choroidal patterns 1, 2, and 3 were identified in 20 (44%), 15 (33%), and 10 (23%) patients with RP, respectively. Several statistically significant correlations were also found. Interestingly, after 1 year of follow-up, only the pattern 3 subgroup showed significant worsening of BCVA, CMT, and OCTA parameters ( P < 0.01)., Conclusions: Choroidal patterns were associated with different RP clinical forms as well as with different progression after 1 year., Translational Relevance: Choroidal patterns evaluation may provide useful clinical information for patients with RP., Competing Interests: Disclosure: A. Arrigo, None; A. Bordato, None; F. Romano, None; E. Aragona, None; A. Grazioli, None; F. Bandello, Allergan (C), Bayer Shering-Pharma (C), Hoffmann-La-Roche (C), NTC Pharma (C), Novartis (C), SIFI (C), SOOFT (C), Thrombogenics (C), Zeiss (C); M. Battaglia Parodi, None, (Copyright 2020 The Authors.)

Purpose: Choroideremia is a rare degenerative retinal disease that causes incurable blindness. It occurs as a result of the deficiency of the X-linked CHM gene, which encodes the Rab escort protein 1 (REP1). Gene therapy has been developed to treat CHM using adeno-associated viral vectors and is currently undergoing clinical trials. Expression of the CHM gene is ubiquitous throughout the retina, and it is therefore important to identify which retinal layers are affected in the disease process. The purpose of this study was to assess in particular the choriocapillaris using optical coherence tomography angiography because this layer is difficult to see with conventional imaging techniques., Methods: Six men with choroideremia were identified and underwent standardized optical coherence tomography angiography as part of an ethics-approved clinical study and were compared with age-matched control subjects., Results: The choriocapillaris appeared normal in regions where the retinal pigment epithelium remained intact, but it was deficient elsewhere. The outer retinal vasculature showed significant changes peripherally but also some changes centrally. The inner retinal vasculature appeared unaffected by the disease process., Conclusion: Choroideremia is a disease in which the choriocapillaris maintains a normal structure until the loss of the overlying retinal pigment epithelium. The inner retina also appears not to be affected at the vascular level. Although this study is limited by the small number of patients eligible for inclusion in the study, the observations support the concept of targeting gene therapy to the retinal pigment epithelium and outer retina because there is no evidence of independent degeneration of the choriocapillaris.

Purpose: To investigate retinal and choroidal microvascular changes and structural choroidal involvement in retinal vein occlusion (RVO)., Methods: Retrospective analysis of treatment-naïve macular edema secondary to RVO, studied by optical coherence tomography (OCT) and OCT angiography (OCTA), before and after the loading phase of intravitreal injections of ranibizumab (IVR-LP). OCTA was performed using two different devices: AngioVue RTVue XR Avanti (spectral-domain OCTA) and Zeiss PLEX® Elite 9000 (swept-source OCTA)., Results: 30 eyes of 30 consecutive patients (17 branch and 13 central RVO) were included. Central macular thickness and subfoveal choroidal thickness (SCT) were significantly reduced after IVR-LP (p < 0.001 and p = 0.046, respectively). 23 eyes were eligible for OCTA analysis. Baseline vessel density (VD) in deep capillary plexus (DCP) was significantly reduced in RVO eyes compared with fellow eyes (p = 0.03 and p = 0.002 for PLEX® Elite and AngioVue, respectively). After IVR-LP, no significant VD changes in any vascular layer was found. PLEX® Elite VD analysis showed significant differences in DCP between ischemic versus non-is-chemic eyes (p = 0.011)., Conclusion: OCTA suggests a retinal vascular impairment of DCP but no involvement of choroid in RVO eyes. A greater baseline SCT could be due to a choroidal exudation. OCTA imaged with PLEX® Elite allowed to differentiate ischemic and non-ischemic patients at baseline., (© 2019 S. Karger AG, Basel.)

Indolent, nonprogressive, multifocal, choroidal lesions represent a newly described, benign, nosological entity that is diagnosed after exclusion of funduscopically similar uveitic and neoplastic processes. Although believed to be a unilateral condition, the authors describe the case of a 63-year-old man presenting with bilateral lesions during a 2-year follow-up conducted by means of optical coherence tomography angiography (OCTA). Surprisingly, OCTA revealed that the vascular rarefaction, albeit primarily affecting the choriocapillaris, also involved the overlying retinal plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:802-805.]., (Copyright 2018, SLACK Incorporated.)

Aims/Purpose: To investigate the quantitative choroidal features associated with the presence of MNV or atrophy in high myopia. Methods: The study was designed as a retrospective, case series with 2‐year follow‐up. Optical coherence tomography (OCT) images were used to measure choroidal thickness (CT) and to assess the presence and subtype of dome‐shaped macula (DSM). In DSM eyes we also calculated the presence and type of choroidal deepening (CD). The eyes were categorized as Subgroup 1 (high myopia without complications), Subgroup 2 (high myopia complicated by macular neovascularization (MNV)) and Subgroup 3 (high myopia complicated by macular or posterior pole atrophy). The main outcome measures were the detection of significant CT cutoffs associated with the three subgroups of eyes and the clinical impact of DSM and CD subtypes. Results: Our study cohort (190 eyes (190 patients) affected by high myopia) was categorized as Subgroup 1 (66 eyes), Subgroup 2 (72 eyes) and Subgroup 3 (52 eyes). The mean axial length was 31.74 ± 2.01 mm (−13.0D ± 2.0D). Baseline CT values allowed to separate the subgroups with myopic‐related complications (AUC 0.85; standard error 0.04; confidence interval 0.78–0.92; p < 0.05). DSM was distributed as follows: Subgroup 1 (39%), Subgroup 2 (44%) and Subgroup 3 (29%). In Subgroup 1, vertical DSM was the most frequent (54%), with CD absence characterizing the 46% of cases. Round DSM was the most represented subtype in Subgroup 2 (49%), with 55% of sub‐dome CD subtypes; in these cases, MNV resulted always localized in the fovea. Subgroup 3 equally showed horizontal or vertical DSM (53% and 47%, respectively), with 80% of cases showing peri‐dome CD. Conclusions: Choroidal quantitative assessment can categorize three high myopia subgroups. MNV subgroup is characterized by intermediate choroidal thinning and higher prevalence of round DSM with sub‐dome CD. DSM subtypes may have a role in predicting myopic complications and MNV localization. [ABSTRACT FROM AUTHOR]

Background: To identify different choroidal patterns in Stargardt disease (STGD) and to assess their clinical correlates. Methods: 100 STGD eyes (29 males; mean age 42.6 ± 16.5 years) and 100 control eyes (29 males; mean age 43.2 ± 8.5 years) were included. Optical coherence tomography (OCT) and OCT angiography (OCTA) images were obtained. Four different choroidal patterns, quantitative OCT and OCTA parameters were assessed and statistically analyzed. The main outcome was the correlation between each choroidal pattern and anatomical and functional retinal status. Furthermore, we assessed structural and best corrected visual acuity (BCVA) changes of each STGD subgroup after one-year. Results: Mean BCVA was 0.63 ± 0.44 LogMAR for STGD patients and 0.0 ± 0.0 LogMAR for controls (p < 0.01). All quantitative parameters appeared deteriorated in STGD compared to controls (p < 0.01). Choroidal patterns were distributed as follows: Pattern 1 (normal appearing choroid) (15%), Pattern 2 (reduced Sattler or Haller layer) (29%), Pattern 3 (reduced Sattler and Haller layers) (26%), Pattern 4 (Pattern 3 + choroidal caverns) (30%). More advanced patterns significantly correlated with a more severe loss of retinal structural integrity. Furthermore, only Pattern 3 and Pattern 4 showed remarkable signs of progression after one year. Conclusions: Choroidal patterns were related with retinal structural status and BCVA loss, and with different disease progression. [ABSTRACT FROM AUTHOR]