Abstract
Pachychoroid spectrum diseases have attracted increasing attention, though their pathophysiology has yet to be fully elucidated. In this study, we assessed the vascular diameters of vortex veins in pachychoroid spectrum diseases such as central serous chorioretinopathy (CSC), pachychoroid neovasculopathy without polypoidal lesions (PNV), and pachychoroid neovasculopathy with polypoidal lesions (polypoidal choroidal vasculopathy: PCV). In a retrospective case series of 94 eyes with CSC, 60 eyes with PNV and 57 with PCV, we binarized en face optical coherence tomography (OCT) images of choroidal vortex veins and analyzed the mean diameter of vortex veins. The presence of anastomosis between the superior and inferior vortex veins and central choroidal thickness (CCT) were also evaluated using OCT images. CSC showed significantly larger mean diameter of vortex veins than PCV (P < 0.05). Anastomosis between superior and inferior vortex veins was observed in over 90% of eyes with each pachychoroid spectrum disease. The patients with CSC were the youngest, followed by PNV patients, and then patients with PCV. The largest CCT values were observed in CSC eyes, followed by PNV eyes, and then PCV eyes. CCT correlated with the mean diameter of vortex veins (rs = 0.51, P < 0.01). These findings suggest that congestion of vortex veins might show gradual amelioration corresponding to the development of anastomosis between the superior and inferior vortex veins during the course of progression of pachychoroid spectrum diseases. Moreover, the mean diameter of vortex veins can be used as a parameter indicating choroidal congestion.
Highlights
Pachychoroid spectrum diseases have attracted increasing attention, though their pathophysiology has yet to be fully elucidated
Using a binarization method, we quantitatively analyzed en face optical coherence tomography (OCT) images of choroidal vortex veins in eyes with central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV)
In all 211 eyes, the central choroidal thickness (CCT) correlated with the area of vortex veins and the mean diameter of vortex veins in en face OCT images
Summary
Pachychoroid spectrum diseases have attracted increasing attention, though their pathophysiology has yet to be fully elucidated. CCT correlated with the mean diameter of vortex veins (rs = 0.51, P < 0.01) These findings suggest that congestion of vortex veins might show gradual amelioration corresponding to the development of anastomosis between the superior and inferior vortex veins during the course of progression of pachychoroid spectrum diseases. No of eyes Age (years) Male Central choroidal thickness (μm) Vortex vein anastomosis ( +) Area of vortex veins (mm2) Length of vortex veins (mm) Mean diameter of vortex veins (μm) and inferior vortex veins was more frequently observed in eyes with pachychoroid spectrum diseases, including CSC, PNV and PCV, than in normal e yes[15,16]. Choroidal neovascularization (CNV) was reportedly present above the pachyvessels in PNV and PCV5,6,15 These reports support the assumption that congestion and remodeling of choroidal vessels might be related to the development of pachychoroid spectrum diseases. Further studies are needed to elucidate the pathophysiology of pachychoroid development and, thereby, to establish optimal treatments
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