Abstract
ObjectivesTo examine the feasibility of automatically segmented choroidal vessels in three-dimensional (3D) 1060-nmOCT by testing repeatability in healthy and AMD eyes and by mapping Haller's and Sattler's layer thickness in healthy eyesMethodsFifty-five eyes (from 45 healthy subjects and 10 with non-neovascular age-related macular degeneration (AMD) subjects) were imaged by 3D-1060-nmOCT over a 36°x36° field of view. Haller's and Sattler's layer were automatically segmented, mapped and averaged across the Early Treatment Diabetic Retinopathy Study grid. For ten AMD eyes and ten healthy eyes, imaging was repeated within the same session and on another day. Outcomes were the repeatability agreement of Haller's and Sattler's layer thicknesses in healthy and AMD eyes, the validation with ICGA and the statistical analysis of the effect of age and axial eye length (AL) on both healthy choroidalsublayers.ResultsThe coefficients of repeatability for Sattler's and Haller's layers were 35% and 21% in healthy eyes and 44% and 31% in AMD eyes, respectively. The mean±SD healthy central submacular field thickness for Sattler's and Haller's was 87±56 µm and 141±50 µm, respectively, with a significant relationship for AL (P<.001).ConclusionsAutomated Sattler's and Haller's thickness segmentation generates rapid 3D measurements with a repeatability correspondingto reported manual segmentation. Sublayers in healthy eyes thinnedsignificantly with increasing AL. In the presence of the thinned Sattler's layer in AMD, careful measurement interpretation is needed. Automatic choroidal vascular layer mapping may help to explain if pathological choroidal thinning affects medium and large choroidal vasculature in addition to choriocapillaris loss.
Highlights
The choroid is a vascular structure that provides the outer retina with oxygen and nutrition [1,2]
Total choroidal thickness is reduced with advanced age[6,7,8] and in prominent outer retinal pathologies such as in age-related macular degeneration (AMD)[9,10]
Pathological choroidal alterations include the reduced choroidal vessel density associated with sub-retinal pigment epithelium (RPE) deposits[11] and the fibrosis observed in AMD and subretinal deposits[12]
Summary
The choroid is a vascular structure that provides the outer retina with oxygen and nutrition [1,2]. The choriocapillaris are a continuous network bordering Bruch’s membrane They branch from the mediumand small-sized vessels in the Sattler’s layer. Total choroidal thickness is reduced with advanced age[6,7,8] and in prominent outer retinal pathologies such as in age-related macular degeneration (AMD)[9,10]. The choriocapillaris layer accounts only for a small proportion of the total choroidal thickness in the healthy eye.[14]Choriocapillaris density decrease in relation to aging, and AMD[11,15,16] explainsthe choroidal pathogenesis in AMD only partially. Choroidal involvement in posterior ocular disease may be further explained by thickness quantification of the medium and large choroidal vessels of the Sattler’s and Haller’s layers
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