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Vascular and structural alterations of the choroid evaluated by optical coherence tomography angiography and optical coherence tomography after half-fluence photodynamic therapy in chronic central serous chorioretinopathy
摘要： Purpose To concurrently evaluate the effect of half-fluence photodynamic therapy (hf PDT) on choriocapillaris (CC) perfusion and choroidal structure in chronic central serous chorioretinopathy (CSC). Methods This prospective study included 48 eyes of 41 patients with chronic CSC. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were analyzed. Choroidal area (CA), luminal area (LA), and stromal area (SA) were computed using Image J software. Results One month after hf-PDT, total CA decreased to 1.312 mm2 from 1.490 mm2 (p < 0.001), LA decreased to 0.981 mm2 from 1.097 mm2 (p < 0.001), and SA decreased to 0.331 mm2 from 0.393 mm2 (p < 0.001). In OCTA, the CC flow in the eyes with CSC (17.75 mm2) was statistically significantly lower than the fellow eyes (18.93 mm2) at the baseline visit (p < 0.001). After hf-PDT, the flow in the choriocapillaris statistically significantly increased to 18.81 mm2 at the first month (p = 0.02). Conclusions OCTA proves that after hf-PDT a significant increase in CC perfusion occurred at first month. The decrease of the luminal areas in enhanced depth imaging optical coherence tomography is mainly due to a decrease in large-caliber vessels, which indicates that hf-PDT has an effect on larger choroidal vessels and spares CC flow.
关键词： Chronic central serous chorioretinopathy,Optical coherence tomography angiography,Half-fluence photodynamic therapy,Choriocapillaris perfusion
更新于2025-09-23 15:23:52
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OCT Angiography of the Choriocapillaris in Central Serous Chorioretinopathy: A Quantitative Subgroup Analysis
摘要： Introduction: To quantify optical coherence tomography angiography (OCTA) signal changes at the level of the choriocapillaris (CC) in patients with different stages of central serous chorioretinopathy (CSC) and to explore any correlation between subretinal fluid (SRF) and retinal pigment epithelium (RPE) alterations and the OCTA CC signal. Methods: One hundred one CSC eyes and 42 healthy control eyes were included in this retrospective study. CSC patients were allocated into four groups: acute, non-resolving, chronic atrophic and inactive CSC. CC OCTA images (AngioPlex?, Zeiss) were automatically quantified using an image-processing algorithm. Spatial correlation analysis of OCTA signals was performed by overlapping macular edema heatmaps and fundus autofluorescence images with corresponding OCTA images. Results: Active CSC subgroups demonstrated significantly more increased and decreased flow pixels in the CC compared with controls (p < 0.0001). No significant OCTA changes were seen within the active CSC groups or between the inactive and healthy subgroup. Spatial correlation analysis revealed a decreased OCTA signal in the SRF area and an increased signal outside the SRF area in acute CSC. Areas of RPE atrophy co-localized with areas of increased choriocapillaris OCTA signal, while areas with RPE alterations exhibited a normal signal compared with unaffected RPE. Conclusion: The decreased OCTA signal in the area of SRF in acute CSC could be evidence of localized CC hypoperfusion or due to shadowing artifacts. The missing CC OCTA changes in altered RPE adjacent to atrophy argues against CC injury. Studies with higher resolution and optimized image acquisition are warranted to further validate our findings.
关键词： Choriocapillaris,OCT angiography,Central serous chorioretinopathy
更新于2025-09-23 15:23:52
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Effect of Anti-VEGF Treatment on Choroidal Thickness over Time in Patients with Neovascular Age-related Macular Degeneration
摘要： Purpose: To evaluate change in subfoveal choroidal thickness (SCT) as measured by spectral-domain optical coherence tomography (SD-OCT) in patients with neovascular age-related macular degeneration (NVAMD) undergoing anti–vascular endothelial growth factor (VEGF) therapy. Methods: Patients with a diagnosis of NVAMD were retrospectively reviewed to identify those who had at least 12 months of follow-up. The SCT was manually measured from Bruch membrane to the choroid–sclera junction at baseline and last follow-up. Only cases in which the choroid was fully visible were included in quantitative analyses. The SCT measurements were correlated with other characteristics including number and duration of treatments. Results: Sixty eyes of 47 patients with a follow-up of 23.8 months (SD 7.3) met study inclusion criteria, and 49 eyes of 40 patients received anti-VEGF treatment. Mean age was 83.7 years, and 52% were female. Treated eyes received a mean of 7.8 (SD 7.3) intravitreal anti-VEGF injections. The SCT at baseline was 126.7 μm (SD 50.6) for untreated and 136.2 μm (SD 57.6) for treated eyes. The SCT showed a decrease over time in both groups, with a mean rate of reduction of 6.0 μm (p<0.0002) in treated eyes and 3.6 μm (p = 0.3741) in untreated eyes. However, the change in SCT did not differ between the groups (p = 0.5113), and did not correlate with the number of re-treatments (p = 0.552), visual acuity at baseline (p = 0.618), or change in visual acuity over time (p = 0.429). Conclusions: Although choroidal thickness decreased over time in eyes with NVAMD, anti-VEGF therapy did not appear to accelerate or otherwise alter this decline.
关键词： Choriocapillaris,Age-related macular degeneration,Optical coherence tomography,Image analysis
更新于2025-09-19 17:15:36
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Assessment of the Dynamic Alteration of Choriocapillaris Vessel Density after Focal Laser Photocoagulation with OCT Angiography
摘要： Purpose. To evaluate the changes of choriocapillaris blood ?ow beneath laser lesions in noncenter-involved diabetic macular edema patients using optical coherence tomography angiography (OCTA). Methods. This was a retrospective case-series study. We used OCTA to analyze the characteristics of the choriocapillaris blood ?ow beneath laser lesions before laser treatment and at several intervals after treatment. The choriocapillaris vessel density (CCVD) beneath the laser lesions was based on the OCTA images and was de?ned as the proportion of ?ow pixels in the selected area calculated using FIJI software through automatic binarization processing based on threshold methods. Results. A total of 63 laser lesions in 8 eyes of 5 patients were included in this study. There was a signi?cant decrease in the CCVD at 1 hour and 1 day following laser treatment (24.25% ± 5.04% and 22.00% ± 4.71%, respectively) when compared with the baseline value (39.09% ± 3.71%, all p < 0.001). The CCVD was 31.82% ± 4.53% in 1 week after laser treatment, which was signi?cantly higher than that in 1 day after treatment (p < 0.001), and then continued to improve at 1 month after treatment (34.44% ± 4.16%). Additionally, in the group with smaller spot size and lower energy, the CCVD recovery at 1 month after laser was signi?cantly better than that in the group with larger spot size and higher energy (p ? 0.006). Conclusions. OCTA image analysis can re?ect changes in the choriocapillaris blood ?ow beneath laser lesions at di?erent times following laser treatment in vivo. Spot size and laser energy may a?ect blood ?ow recovery.
关键词： laser photocoagulation,choriocapillaris,diabetic macular edema,OCT angiography
更新于2025-09-19 17:13:59
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Retinal and Choroidal Perfusion Status in the Area of Laser Scars Assessed With Swept-Source Optical Coherence Tomography Angiography
摘要： To evaluate the perfusion status of the retina and choriocapillaris in the area of laser scars on swept-source optical coherence tomography angiography (OCTA) images of eyes previously treated with panretinal photocoagulation (PRP).
关键词： diabetic retinopathy,OCT angiography,laser photocoagulation,choriocapillaris
更新于2025-09-11 14:15:04
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Morphometrical evaluation of the choriocapillaris imaged by swept-source optical coherence tomography angiography
摘要： Purpose: To assess the reproducibility of quantitative morphometrical evaluation of the choriocapillaris imaged with swept-source optical coherence tomography angiography (SS-OCTA). Subjects and methods: This observational, cross-sectional case series included 35 eyes of healthy individuals and 32 eyes of 32 patients. Two images of the fovea were taken using SS-OCTA with 3×3 mm squares. Images of the choriocapillaris within 800×800 pixel squares centered at the fovea were analyzed morphometrically using open-source software “AngioTool” that applies a Gaussian recursive filter and multiscale Hessian enhancement. This program’s vessel thickness and intensity parameters can be changed to aid vessel detection. We measured the pairs of images per eye with different parameter sets and calculated the intraclass correlation (ICC) for the morphometrical results. After determining the parameters that produced high reproducibility, we evaluated regional variations in 800×800 pixel mm squares within the fovea. Results: The ICCs for vessel area, total vessel length, vessel diameter index, and mean lacunarity were over 0.9 using the parameters of “vessel thickness” 3–4 and intensity 15 in the group including all subjects. When measurements were performed using these same parameter values, the vessel density and mean vessel diameter index were 60.5% and 19.1±0.389, respectively. Vessel density, vessel length, vessel diameter index, and mean lacunarity did not change significantly within an 800×800 pixel square centered at the fovea except for the 200×200 pixel square at the foveal center. Conclusion: SS-OCTA images of the choriocapillaris can be measured with high reproducibility by morphometrical evaluation using open-source software with multiscale Hessian enhancement. Such automated morphometric analysis can provide an objective evaluation of the choriocapillaris.
关键词： choriocapillaris,swept-source optical coherence tomography angiography,morphometry,vessel density
更新于2025-09-10 09:29:36
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Improving visualization and quantitative assessment of choriocapillaris with swept source OCTA through registration and averaging applicable to clinical systems
摘要： Choriocapillaris (CC) visualization and quantification remains challenging. We propose an innovative three-step registration and averaging approach using repeated swept source optical coherence tomography angiography (SS-OCTA) scans to conduct automatic quantitative assessment on CC. Six subjects were enrolled, each imaged at several locations with SS-OCTA from macular to equatorial regions using 3 mm × 3 mm scanning pattern. Five repeated volumes were collected for each subject. The complex optical microangiography (OMAG) algorithm was applied to identify blood flow in CC slab. An automatic three-step registration of translation, affine and B-Spline was applied to en face OCTA images of CC, followed with averaging. A fuzzy clustering approach was used to segment vasculature and flow deficits from the averaged images. The improvement in visualization of CC was evaluated and the average intercapillary distance was estimated by calculating the averaged capillary lumen spacing. A series of quantitative indices of flow deficit density, number, size, complexity index and aspect ratio index (FDD, FDN, FDS, FDCI and FDARI) were designed and validated with the increase of repeated scan numbers for averaging. Quantitative assessment was applied and compared on CC in macular and equatorial regions. The intercapillary distance was observed to be around 24 μm at macula and increased toward equatorial regions. All five quantitative indices (FDD, FDN, FDS, FDCI and FDARI) showed significant changes with multiple averaging and tend to become stable with repeated number of 4. Our proposed registration and averaging algorithm significantly improved the visualization of CC with SS-OCTA. The designed five indices for CC provide more options in the quantitative assessment of CC and are of great potentials in assisting the understanding of disease pathology, early diagnosis and treatment monitoring.
关键词： quantitative assessment,optical coherence tomography angiography,choriocapillaris,averaging,registration
更新于2025-09-10 09:29:36
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Different Filling Patterns of the Choriocapillaris in Fluorescein and Indocyanine Green Angiography in Primate Eyes Under Elevated Intraocular Pressure
摘要： To investigate the hemodynamics of the choriocapillaris in primate eyes under elevated intraocular pressure. Indocyanine green angiography (ICGA) and fluorescein angiography (FA) were performed in two monkeys after elevation of the intraocular pressure (IOP) to 35 and 60 mm Hg. ICGA and FA showed no perfusion delays in the choriocapillaris at 35 mm Hg. The slow dye filling at 60 mm Hg made it possible to observe the early phase angiography sequence. During ICGA, C-shaped precapillary arterioles multiplied in numbers and emerged in the posterior pole, forming the outer rim of the numerous mosaics or lobules. Dye subsequently infiltrated into the lobules. During FA, after numerous hyperfluorescent spots emerged in the posterior pole, each of the spots enlarged and became numerous mosaics with a dark outer rim. When the FA and ICGA images were superimposed, the C-shaped arterioles observed during the ICGA were shown to correspond to the outer dark rim of the mosaics seen during the FA. The earliest dye emergence was delayed during FA compared to ICGA, with 13 seconds elapsing in monkey 1 and 4 seconds in monkey 2. The horizontal diameter of the optic disc contained three to four mosaics in both monkeys. The choriocapillaris lobules appear to be supplied from peripheral arterioles, not central. After blood perfuses the lobules, it drains into the venules at the center. Mosaic or lobular patterns during FA may reflect extravasated fluorescein from the fenestrated choriocapillaris.
关键词： central venule theory,angiography,choriocapillaris
更新于2025-09-10 09:29:36