Choroidal Vessel Density Research Articles

Vascular Changes and Irreversible Complications in 120° Fundus Using Widefield SS-OCTA in Vogt-Koyanagi-Harada Disease.

To characterize the changes of fundus corresponding to 120° field of view in chronic Vogt-Koyanagi-Harada (VKH) disease in the quiescent phase, and explore the associations with irreversible complications in the fundus utilizing widefield swept source optical coherence tomography angiography (SS-OCTA). Prospective cross-sectional study. Sixty-nine chronic VKH patients (115 eyes) and 55 healthy controls (110 eyes) were included and underwent widefield SS-OCTA. Univariate analyses of variations in retinal and choroidal vessel density (VD), choroidal volume, and choroidal vascularity index (CVI) in VKH patients with different disease durations and the controls were conducted. Logistic regression analysis was employed to identify the associations with irreversible complications including choroidal neovascularization, vasoproliferative tumour of the retina, and chorioretinal atrophy. The Welch's analysis of variance showed lower VD of superficial retina, deep retina, choriocapillaris, and large-sized and medium-sized vessels of the choroid (LMVC), and choroidal volume and CVI in the patients with disease duration > 24 months compared to those with disease duration ≤ 24 months (all P≤0.011). The regression analysis revealed the disease duration (P=0.008; OR=1.02, 95%CI=1.005-1.035) and VD of LMVC (P=0.001; OR=0.707, 95%CI=0.575-0.87) were significantly correlated with the irreversible complications. Chronic VKH patients in the quiescent phase with disease duration > 24 months exhibit more severe decreased VD in each layer of the retina and choroid, reduced choroidal volume and sparse choroidal vascularity compared to those with disease duration ≤ 24 months. Prolonged duration and decreased VD of LMVC were associated with irreversible complications in the fundus.

The effect of heart rate variability on the choroidal vascularity of the optical coherence tomography and angiography in central serous chorioretinopathy.

To investigate the correlation between the autonomic nervous system and choroidal vascularity in patients with central serous chorioretinopathy (CSC), using heart rate variability (HRV) analysis, optical coherence tomography (OCT) and OCT angiography (OCTA). We retrospectively analyzed data of 25 patients with unilateral CSC (50 eyes, including the unaffected fellow eyes) and 25 healthy controls. The assessment involved a 5-minute HRV analysis encompassing both frequency and time domains, especially low frequency (LF), high frequency (HF), and LF/HF ratio. In OCT (12 × 9mm) and en-face OCTA (3 × 3mm) scans, we measured parameters including choroidal vascularity index (CVI), choroidal vessel density in the middle and deep layers, and choriocapillaris flow void. Regression analysis was conducted to elucidate the associations between HRV parameters and OCT/OCTA measurements. Normalized LF(LFnorm) and LF/HF ratios were higher in patients with CSC than in healthy controls. LFnorm and the log-transformed ratio of LF to HF [log(LF/HF)] demonstrated a significant and borderline correlation with CVI in the linear regression analysis (P = 0.040, R2 = 0.171, and P = 0.059, R2 = 0.147, respectively). Both CVI and deep choroid vessel density showed a more significant association with LFnorm and log (LF/HF) in the non-linear quadratic regression analysis than in the linear analysis (all, P < 0.04, R2 > 0.25). The frequency-domain parameters of HRV, including LFnorm and log (LF/HF), demonstrated a significant association with indicators reflective of large choroidal vessel luminal area on macular OCT/OCTA scans. This observation implies complicated modulation of choroidal blood flow by the autonomic nervous system in CSC.

Quantitative microvascular analysis in different stages of retinitis pigmentosa using optical coherence tomography angiography

As retinitis pigmentosa (RP) is chronic and progressive, the chronological sequence of microvascular changes is important for understanding its pathophysiology. We aimed to investigate retinal and choroidal microvascular changes according to the RP stages. The stages of RP were classified into three stages according to the integrity and width of the inner segment ellipsoid zone: early, ≥ 2500 μm; moderate, < 2500 μm; advanced, absence. Using optical coherence tomography angiography, quantitative microvascular parameters were analyzed. In total, 91 eyes from 49 patients were included. For the superficial capillary plexus (SCP) and deep capillary plexus (DCP), perfusion densities (PDs) in the early stage (SCP: 37.32 ± 8.11%; DCP: 21.19 ± 9.15%) were greater than those in moderate (SCP: 34.16 ± 6.65%, P = 0.011; DCP: 15.67 ± 8.85%, P = 0.031) and advanced stages (SCP: 33.71 ± 9.02%, P = 0.030; DCP: 12.83 ± 6.29%, P < 0.001). The choroidal vascularity index in the early stage (0.58 ± 0.03) was greater than those in the moderate (0.57 ± 0.02, P = 0.017) and advanced stage (0.56 ± 0.02, P = 0.033). The area and perimeter of foveal avascular zone (FAZ) in advanced stage (0.44 ± 0.26 mm2, 2.96 ± 0.86 mm, respectively) were larger than those in early (0.26 ± 0.11 mm2, P = 0.020; 2.19 ± 0.53 mm, P = 0.006, respectively) and moderate stage (0.28 ± 0.13 mm2, P = 0.043; 2.24 ± 0.67 mm, P = 0.013, respectively). During RP disease progression, retinal and choroidal microvascular vessel density decreases in the early stage, followed by FAZ enlargement in the advanced stage.

Assessment of retinal and choroidal vessel density and nerve fibre layer thickness changes after orbitotomy in patients with severe non-active thyroid orbitopathy: a prospective study.

To evaluate the optical coherence tomography angiogram changes in non-active severe thyroid-related ophthalmopathy patients after cosmetic bone decompression. Eighteen patients (25 eyes) with severe not active not compressive (NANC) TED who were candidates for decompression surgery for cosmetic reasons were included in this study, and a 3 × 3mm macular scan was used to measure vessel density and RNFL thickness. Whole macular vessel density in its superficial, deep and choriocapillaris layers was evaluated. The following data were extracted for each of layers: superior and inferior hemispheres, fovea, parafoveal vessel density, its superior and inferior hemispheres, and temporal, superior, nasal and inferior quadrant. The mean RPC increased postoperatively, which was statistically significant in small vessels of peripapillary area (p-value = 0.045). The mean RNFL thickness decreased after surgery and it was statistically significant in the peripapillary (p-value = 0.032) and Inferior-Hemifield area (p-value = 0.036). The choriocapillaris changes were significant in Superior-Hemifield (p-value = 0.031) and Fovea (p-value = 0.03). Thyroid-associated orbitopathy patients have a tendency to decrease vascular density and correlated with disease activity more than stage of orbitopathy. There was not a strong and even discrepant result in linkage of RNFL thickness and other optic nerve function tests and TED patient status and it is needed to do studies with more epidemiologic power and same methodology of study to be more comparable.

Choroidal vessel density in major depressive disorder using swept-source optical coherence tomography angiography

BackgroundPrevious studies have revealed the retinal structural impairment in major depressive disorder (MDD). The choroid is more affected by systemic changes compared to the retina and provides nutrients to the retina. It is uncertain whether the choroidal structure was damaged in MDD. Therefore, this study aimed to investigate choroidal vessel density (VD) in MDD patients using swept-source optical coherence tomography angiography (SS-OCTA). MethodsThis study investigated the choroidal and retinal VD of subjects with SS-OCTA. MDD was identified based on the Diagnostic and International Classification of Diseases, 10th edition (ICD-10). The VD was automatically calculated as the ratio of the pixel areas of the vessels divided by the total area of the regions by the device. ResultsCompared with healthy controls (HCs) (n = 45 eyes), the MDD group (n = 66 eyes) demonstrated significantly lower supranasal and temporal choroidal vessel volume (CVV), temporal choroidal vessel volume index (CVI), and supranasal and temporal choroidal stroma volume (CSV) (all p < 0.05). After adjustment for age and sex, we found that temporal CVV (β = −9.31, p = 0.040) and supranasal (β = −15.28, p = 0.034) and temporal CSV (β = −11.82, p = 0.036) were significantly associated with MDD. Both choroidal thickness and retinal VD indicators did not differ significantly between MDD patients and HCs (both p > 0.05). LimitationsConclusions about progressive changes in choroidal vascular structures during the course of MDD are limited by the our cross-sectional study. ConclusionsWe found the choroidal VD in MDD was lower compared with HCs, which suggests that decreased choroidal VD is associated with the MDD.

Changes in the choroid detected by ultrawide-field optical coherence tomography angiography in type 2 diabetes mellitus patients without diabetic retinopathy

AimThe study objective was to investigate the choroidal changes in type 2 diabetes mellitus (T2DM) patients without diabetic retinopathy (DR). MethodsThis was a cross-sectional study. Controls without diabetes and T2DM patients without DR (NDR) were included. Ultrawide-field (24 × 20 mm2) optical coherence tomography angiography (OCTA) was performed to analyse choroidal thickness and vessel density. All OCTA images were divided into 3 × 3 grids. The grid centre was considered the central area, while the rest was defined as the peripheral area. ResultsNo differences between groups were observed in the flow density of the choriocapillaris (CC), choroidal thickness (ChT) and choroidal vascular index (CVI) of the large and medium choroidal vessel (LMCV) in the central area. In the eight peripheral areas, the mean flow density of the CC did not differ between the groups, while the mean CVI and ChT were decreased in the NDR group (P< 0.05). In each peripheral area, the mean CVI and ChT were decreased in the NDR group (P< 0.05, except in the infratemporal area and nasal area for ChT and in the infratemporal area for CVI). In the correlation analysis, both mean peripheral CVI and ChT correlated with age and the duration of diabetes. ConclusionEarly choroidal lesions tended to be peripheral in the LMCV in patients with diabetes without DR and correlated with age and the duration of diabetes.

Relationship of Choroidal Microvasculature Dropout and Beta Zone Parapapillary Area With Visual Field Changes in Glaucoma

To evaluate the association between rates of choroidal microvasculature dropout (MvD) change, beta zone parapapillary atrophy (β-PPA) area change, and visual field (VF) changes in eyes with primary open-angle glaucoma (POAG). Retrospective, observational cohort study. In a tertiary glaucoma clinic, we included 76 eyes from 58 patients with POAG with and without localized MvD, who had ≥2 years of follow-up with a minimum of 4 visits with optical coherence tomography angiography and optical coherence tomography scans. β-PPA area was evaluated using scanning laser ophthalmoscopy-like images and compared with the area of MvD on an en face choroidal vessel density map during the follow-up period. Joint longitudinal mixed effects models were used to estimate the rates of change in β-PPA area or MvD area and VF mean deviation (MD). Mean rates of change in β-PPA and MvD area were 0.037 mm2 (95% confidence interval [CI] 0.030-0.043 mm2) per year and 0.039 mm2 (95% CI 0.029-0.048 mm2) per year, respectively, over the mean follow-up of 4.1 years. In multivariable models, MvD area enlargement was significantly associated with faster rates of VF MD loss (0.03 mm2 [95% CI 0.02-0.04 mm2] per 1-dB worse, P < .001) but not β-PPA area enlargement (0.04 mm2 [95% CI 0.03-0.05 mm2] per 1-dB worse, P=.252). MvD area rates, but not β-PPA area rates, were associated with VF MD loss changes in eyes with POAG. Assessment of MvD is useful for the detection of patients with glaucoma who are at an increased risk of faster VF loss.

Association Between Optic Disc Perfusion Determined by Swept-Source Optical Coherence Tomography Angiography and Visual Field Progression in Glaucoma.

Reduced optic disc vessel density determined by swept-source optical coherence tomography angiography (SS-OCTA) was associated with visual field (VF) deterioration in glaucomatous eyes, which suggested that this parameter can be a potential biomarker that correlates well with functional deterioration. The purpose of this study was to identify the association between optic disc perfusion evaluated by SS-OCTA and VF progression in primary open angle glaucoma (POAG) eyes. A total of 266 POAG eyes of 266 patients (5.4y of mean follow-up) were included. Optic nerve head SS-OCTA was performed to evaluate the optic disc vessel density (dVD), parapapillary choroidal vessel density (pcVD), choroidal microvascular dropout (cMvD), and optic disc microvascular dropout (dMvD). VF progression was defined using Early Manifest Glaucoma Trial criteria. Factors associated with VF worsening were assessed by Cox proportional hazard analysis. Eighty (30.1%) out of the 266 POAG eyes showed VF progression. The progression group showed a significantly higher proportion of disc hemorrhage, cMvD, and dMvD but lower dVD and pcVD than the stable group (all P <0.05). Considering the strong association between the parameters [dMvD vs. dVD ( r = -0.757, P =0.010], cMvD vs. pcVD ( r = -0.745, P =0.012), dMvD vs. cMvD ( r = 0.802, P <0.001], dVD vs. pcVD ( r = 0.862, P <0.001), CMvD vs. dVD ( r = -0.698, P =0.031), and dMvD vs. pcVD ( r = -0.688, P =0.034)], 6 models with different combinations of covariates compensating for multicollinearity were developed. Younger age, presence of disc hemorrhage, and lower dVD were consistently associated with progression in all models that included these parameters. Optic disc perfusion, represented as dVD, may be a useful biomarker that correlates well with functional deterioration in POAG eyes.

Widefield choroidal vasculature associated with future condition of subretinal fluid in central serous chorioretinopathy

PurposeTo examine choroidal angiographic features in the posterior pole associated with resolution or persistency of subretinal fluid (SRF) in eyes with central serous chorioretinopathy (CSC). DesignObservational case series. MethodsTwenty-nine patients with treatment-naïve CSC were divided into two groups based on the presence or absence of SRF 3 months after the initial visit (month 3) without any treatment. Using enhanced depth imaging of widefield swept-source optical coherence tomography, the choroidal thickness (CT), vessel density (VD), and vessel diameter index (VDI) in the superotemporal and inferotemporal subfields on the temporal side of the 18-mm circle from the disc were measured at the initial visit. We calculated the vertical difference in CT and other choroidal angiographic parameters and evaluated their association with the SRF condition at 3 months. ResultsThe SRF-resolved and SRF-persistent groups included 10 and 19 patients, respectively. At the initial visit, sex, age, axial length, symptom duration, the logarithm of the minimum angle of resolution visual acuity, and foveal thickness were not significantly different between the two groups. The SRF status at month 3 was not associated with the vertical difference in CT and choroidal VD (P = .614, .065, respectively). However, the vertical difference in choroidal VDI was positively associated with the future presence of SRF (P = .017). ConclusionsVertically asymmetric dilation of choroidal vessels in the posterior pole may be a vasculature feature associated with SRF from CSC and may be a good predictor of future SRF status.

MULTIMODAL IMAGING IN NONEXUDATIVE CHOROIDAL NEOVASCULARIZATION: A Pilot Study of Status of Retinal Pigment Epithelium.

To study the status of retinal pigment epithelium in nonexudative and active choroidal neovascularization (CNV) in neovascular age-related macular degeneration. Only treatment-naïve neovascular age-related macular degeneration patients were enrolled in this prospective case-control study, including 17 eyes with nonexudative CNV (6 males and 11 females, 74.9 ± 10.0 years) and 28 eyes with active CNV (8 males and 20 females, 69.3 ± 6.8 years). All patients received a comprehensive ophthalmic examination, optical coherence tomography, dark-field scanning laser ophthalmoscopy, and fundus autofluorescence. The status of the retinal pigment epithelium was assessed with ImageJ software as the brightness of the CNV region on transillumination optical coherence tomography, dark-field scanning laser ophthalmoscopy, and fundus autofluorescence images. Choroidal neovascularization vessel density was measured based on optical coherence tomography angiography. The brightness of CNV region in nonexudative CNV was statistically significantly lower than in active CNV with both optical coherence tomography transillumination ( P = 0.004) and dark-field scanning laser ophthalmoscopy ( P = 0.0015). No difference in brightness of the CNV region between nonexudative and active CNV was found based on fundus autofluorescence ( P = 0.44). The vessel density of nonexudative CNV was statistically significantly higher than that of active CNV with a median value of 64.5% (95% confidential interval [CI] 53.4-79.0%) and 55.3% (95% CI 52.2-60.0%), respectively ( P = 0.05). Multimodal imaging revealed substantial alteration of the retinal pigment epithelium in active CNV but not in nonexudative CNV which correlates with the higher vessel density of nonexudative CNV.

Quantitative assessment of the choroidal vasculature in myopic macular degeneration with optical coherence tomographic angiography.

To assess and compare choroidal morphometric vascular parameters, using optical coherence tomographic angiography (OCTA), in highly myopic adults with and without myopic macular degeneration (MMD). This is a clinic-based observational study of 148 eyes with axial length (AL) ≥25mm, enrolled from the high myopia clinic of the Singapore National Eye Centre. MMD was graded from fundus photographs. Swept source OCT (SS-OCT) and OCTA were performed and assessed for choroidal layer thickness (CT) and choroidal vasculature (choroidal vessel density (CVD), choroidal branch area (CBA) and mean choroidal vessel width (MCVW)) in the different choroidal layers (overall choroidal layer (CL), medium-vessel choroidal layer (MVCL), large-vessel choroidal layer (LVCL)). CTCL (r=-0.58, p<0.001), CTMVCL (r=-0.22, p=0.04), MCVWCL (r=-0.58, p<0.001), and CVDCL (r=-0.19, p=0.02) were negatively correlated with AL, while CBACL (r=0.61, p<0.001) was positively correlated. Compared to eyes with no MMD, eyes with MMD2 had lower CTCL (120.37±47.18µm vs 218.33±92.70µm, p<0.001), CTMVCL (70.57±15.28µm vs 85.32±23.71µm, p=0.04), CTLVCL (101.65±25.36µm vs 154.55±68.41µm, p=0.001) and greater CVDCL (71.10±3.97% vs 66.97±3.63%, p<0.001), CVDMVCL (66.96±2.35% vs 65.06±2.69%, p=0.002), CVDLVCL (68.36±2.56% vs 66.58±2.88%, p=0.012), MCVWMVCL (6.14±0.34µm vs 5.90±0.35µm, p=0.007), and CBACL (12.69±1.38% vs 11.34±1.18%, p<0.001). After adjusting for age, thicker CTCL (odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97-0.99, p<0.001), CTMVCL (OR 0.97 (0.94-0.99), p=0.002) and CTLVCL (OR 0.97 (0.96-0.98, p<0.001) were significantly associated with lower odds of MMD2, while increased CVDCL (OR 1.37 (1.20-1.55), p<0.001), CVDMVCL (OR 1.39 (1.12-1.73), p=0.003), CVDLVCL (OR 1.31 (1.07-1.60), p=0.009), CBACL (OR 2.19 (1.55-3.08), p<0.001) and MCVWMVCL (OR 6.97 (1.59-30.51), p=0.01) was significantly associated with higher odds of MMD2. Decrease in choroidal vessel width, density and thickness, and an increase in vascular branching were observed in eyes with long AL. A thinner and denser choroid with greater branching area and vessel width, which may all be signs of hypoxia, were associated with greater odds of MMD2.

Quantitative Analysis of Choroidal Morphology Using Multimodal Imaging in Acute and Persistent Central Serous Chorioretinopathy.

To analyze quantitative differences in choroidal morphology between acute and persistent central serous chorioretinopathy (CSC) using multimodal images. Ultra-widefield indocyanine green angiography (UWICGA) and optical coherence tomography (OCT) images of 72 eyes of 72 patients with acute (32 eyes) and persistent (40 eyes) CSC were collected. Choroidal thickness, area, vessel density, symmetry, and intervortex anastomosis were assessed. The choroidal area on OCT B-scan images was smaller and the choroidal vessel density on UWICGA images was lower in the persistent group (P < 0.001 and P = 0.028, respectively). Choroidal vessel density on UWICGA showed positive correlation with that of vortex ampullae (all P ≤ 0.046). The constitution of the intervortex anastomosis and dominant vessels in the macular area showed differences between the groups (P = 0.014 and P = 0.010, respectively), with greater inferonasal vessel participation in the anastomosis and combined supero- and inferotemporal vessels as dominant vessels in the persistent groups. Acute and persistent CSC differed in subfoveal choroidal area, choroidal vessel density, intervortex anastomosis constitution on UWICGA images. Choroidal vessel density on UWICGA images correlated with that of vortex ampullae. These findings enhance our understanding of the pathophysiology of CSC subtypes.

Change of Choroidal Microvasculature Dropout After Trabeculectomy as Assessed by Optical Coherence Tomography Angiography.

Reduction in the angular circumference of choroidal microvascular dropout (CMvD AC) was found in POAG patients after trabeculectomy. Greater percentage of IOP reduction was significantly associated with decreased CMvD AC. The purpose of this study was to investigate the change of choroidal microvasculature dropout (CMvD) after trabeculectomy and its associated factors in primary open angle glaucoma (POAG) eyes using optical coherence tomography angiography. Fifty eyes of 50 POAG participants who had preoperative CMvD and underwent trabeculectomy were prospectively enrolled. Angular circumference (AC) of CMvD was determined from choroidal layer images by optical coherence tomography angiography preoperatively and at postoperative 1 year. The cutoff for significant AC of CMvD decrease was determined by the Bland-Altman method, and accordingly, patients were divided into 2, decreased and stable/increased CMvD AC groups. Changes in intraocular pressure (IOP) and CMvD AC were compared between the groups preoperatively and at postoperative 1 year. Factors associated with CMvD AC decrease were assessed by linear regression analysis. The cutoff for significant CMvD AC decrease was 3.58 degrees; accordingly, 26 eyes (52.0%) were categorized as decreased CMvD AC group. No significant intergroup differences in baseline characteristics were found. However, the decreased CMvD AC group presented significantly lower IOP (10.7±3.7 vs. 12.9±2.6mmHg, P =0.022), lower CMvD AC (32.03±33.95% vs. 53.44±39.33%, P =0.044), and higher parapapillary choroidal vessel density ( P =0.014) compared with the increased/stable CMvD AC group at postoperative 1 year. The greater percentage of IOP reduction was significantly associated with decreased CMvD AC ( P =0.046). CMvD AC reduction associated with IOP lowering was found after trabeculectomy. The long-term clinical relevance of postoperative CMvD reduction should be further investigated.

The effect of acetazolamide on the retinal and choroidal vasculature of the macula and the optic disc using OCT angiography

Introduction and objectivesTo investigate the effect of acetazolamide (AZ) on the retinal and choroidal ocular microvasculature in the macula and radial peripapillary capillaries (RPC) of the optic disc with OCT Angiography (OCTA). Materials and methodsNine-month observational cross-sectional study. Forty-five eyes from 45 healthy participants who underwent cataract surgery were recruited. Macular retina and choriocapillaris vessel density (VD) and RPC VD in the optic disc area were compared before and 60min after 250mg acetazolamide per os. Intraocular pressure (IOP) and systemic blood pressure (BP) were also measured before each scan. ResultsMean age was 73.1±6.9 years. VDs in the superficial (SCP) and deep (DCP) capillary plexus of the retina and the choriocapillaris (CC) in the macular area showed no significant change (P>.5, for all parameters). VD in the RPC showed no significant change with AZ (P>.5, for all parameters). Foveal and parafoveal thickness increased from 248.98 (±23.89) to 250.33 (±23.74) and from 311.62 (±16.53) to 311.98 (±16.38) (P<.001 and P=.046), respectively. IOP decreased from 13.2 (±3.0) mmHg to 11.8 (±3.2) mmHg (P<.001), while systolic and diastolic BP decreased from 144.8 (±21.8) to 137.7 (±19.0) and from 80.0 (±12.7) to 76.2 (±11.7) (P=.021 and P=.030), respectively. ConclusionsOCTA imaging did not reveal any significant changes in the VD of the optic disc or the retinal and choroidal VD in the macula with oral AZ one hour after its administration in otherwise healthy participants who underwent cataract surgery.

Efecto de la acetazolamida en la vasculatura retiniana y coroidea de la mácula y el disco óptico mediante angiografía OCT

Introduction and objectivesTo investigate the effect of acetazolamide (AZ) on the retinal and choroidal ocular microvasculature in the macula and radial peripapillary capillaries (RPC) of the optic disc with OCT Angiography (OCTA). Materials and methodsNine-month observational cross-sectional study. Forty-five eyes from 45 healthy participants who underwent cataract surgery were recruited. Macular retina and choriocapillaris vessel density (VD) and RPC VD in the optic disc area were compared before and 60minutes after 250mg acetazolamide per os. Intraocular pressure (IOP) and systemic blood pressure (BP) were also measured before each scan. ResultsMean age was 73.1±6.9 years. VDs in the superficial (SCP) and deep (DCP) capillary plexus of the retina and the choriocapillaris (CC) in the macular area showed no significant change (p>0.5, for all parameters). VD in the RPC showed no significant change with AZ (p>0.5, for all parameters). Foveal and parafoveal thickness increased from 248.98 (±23.89) to 250.33 (±23.74) and from 311.62 (±16.53) to 311.98 (±16.38) (p<0.001 and p=0.046), respectively. IOP decreased from 13.2 (±3.0) mmHg to 11.8 (±3.2) mmHg (p<0.001), while systolic and diastolic BP decreased from 144.8 (±21.8) to 137.7 (±19.0) and from 80.0 (±12.7) to 76.2 (±11.7) (p=0.021 and p=0.030), respectively. ConclusionsOCTA imaging did not reveal any significant changes in the VD of the optic disc or the retinal and choroidal VD in the macula with oral AZ one hour after its administration in otherwise healthy participants who underwent cataract surgery.

Reduced intradisc vessel density is associated with optic disc hemorrhage in eyes with primary open-angle glaucoma

We sought to investigate the association between optic nerve head (ONH)/choroidal microvasculature perfusion and optic disc hemorrhage (ODH) in eyes with primary open-angle glaucoma (POAG) using swept-source optical coherence tomography angiography (SS-OCTA). A total of 266 POAG eyes (59 with a single instance of ODH, 40 with a history of recurrent ODH, and 167 eyes without ODH) with a mean follow-up of 5.4 years were included. Intradisc vessel density (VD), parapapillary choroidal VD, optic disc microvascular dropout (MvD), and choroidal microvascular dropout (CMvD), were evaluated on a 3 × 3 mm SS-OCTA image of ONH and compared between eyes with and without ODH. Recurrent ODH was defined as occurrence 1 year after first ODH detection during the total follow-up period. Logistic regression analyses were performed to investigate factors associated with ODH. The prevalence of CMvD, optic disc MvD, and β-parapapillary atrophy were not different among the no ODH, single ODH, and recurrent ODH groups. Eyes with ODH had lower intradisc VDs than those without ODH (P = 0.021), but no difference was found in intradisc VDs between the single and recurrent ODH groups (P = 0.977). Better VF MD at baseline (odds ratio [OR], 1.150; 95% confidence interval [CI], 1.055–1.254; P = 0.002) and lower intradisc VD (OR, 0.863; 95% CI, 0.812–0.918; P < 0.001) were associated with ODH occurrence. Among POAG eyes, those with ODH had lower intradisc VDs than those without ODH. POAG eyes in an earlier disease stage or those with lower intradisc VDs should be monitored for the possibility of ODH occurrence.

Choroidal Morphology on Ultra-Widefield Indocyanine Green Angiography and Response to Aflibercept in Pachychoroid Neovasculopathy.

This study assessed the relationship between the choroidal morphology and short-term response to aflibercept treatment in pachychoroid neovasculopathy (PNV). This was a retrospective case-control study. Ultra-widefield indocyanine green angiography (UWICGA) and optical coherence tomography (OCT) images of 90 PNV eyes of 90 patients treated with aflibercept were enrolled. Responsiveness to aflibercept was defined as a complete resolution of sub- or intra-retinal fluid after three loading doses (50 dry and 40 non-dry eyes). Subfoveal choroidal thickness (SFCT) was measured on OCT images, and choroidal vessel density (CVD), CVD asymmetry, intervortex anastomosis, and choroidal vascular hyperpermeability (CVH) were assessed on UWICGA images. CVD on UWICGA differed between groups in terms of the total area (0.323 ± 0.034 in dry vs. 0.286 ± 0.038 in non-dry, p &lt; 0.001) and area of each quadrant (superotemporal: 0.317 ± 0.040 vs. 0.283 ± 0.040, superonasal: 0.334 ± 0.040 vs. 0.293 ± 0.045, inferonasal: 0.306 ± 0.051 vs. 0.278 ± 0.052, inferotemporal: 0.334 ± 0.047 vs. 0.290 ± 0.046; all p ≤ 0.010). The CVH grade differed between groups (mean 1.480 ± 0.735 vs. 1.875 ± 0.822, p = 0.013). ST and IT intervortex anastomoses were common in the dry group, while SN, ST, and IT were most common in the non-dry group (p = 0.001). A poor short-term response to aflibercept treatment in PNV eyes was associated with a lower Haller vessel density, higher CVH grade, and intervortex anastomosis involving more quadrants on UWICGA.

Comparison of Chorioretinal Parameters in Diabetic Retinopathy with or without Pan-Retinal Photocoagulation Using Ultrawide-Field Swept-Source Optical Coherence Tomography Angiography

Introduction: To compare structural and vascular parameters in the central and peripheral retina and choroid of eyes diagnosed with severe nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) with or without pan-retinal photocoagulation (PRP) using ultrawide-field swept-source optical coherence tomography angiography (SS-OCTA). Methods: All participants underwent SS-OCTA imaging centered on the fovea. Retinal and choroidal thickness, vessel density of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary plexus (CCP), and choroidal Sattler’s and Haller’s layer (CSHL) were analyzed in nine grids using built-in angiography analysis software. Results: A total of 82 eyes from 82 participants were enrolled in this study, including 40 eyes diagnosed with severe NPDR or PDR without PRP and 42 eyes with PRP. Retinal thickness in part grids was higher in eyes with PRP than in eyes without PRP. Vessel density of the SCP in nasal-superior (p = 0.003) grid was lower in eyes with PRP than in eyes without PRP. No significant difference was found in the vessel density of the DCP between the two groups (all p > 0.05). The choroidal thickness and vessel density of the CSHL of all grids were significantly lower in eyes with PRP than in eyes without PRP (all p < 0.05). A statistically significant decrease in vessel density in CCP was found in the superior (p = 0.043), nasal-superior grid (p = 0.003), macular grid (p < 0.001), and optic disc grid (p = 0.001) of eyes with PRP, compared to eyes without PRP. A significant decrease in the vessel density of CSHL was observed in all grids of PDR eyes with PRP compared to PDR eyes without PRP (all p < 0.05). Significant decrease in choroidal thickness was observed in most grids of PDR eyes with PRP, except for macular grid (p = 0.090) and optic disc grid (p = 0.057). Conclusion: Structural and vascular parameters in the central and peripheral retinal and choroidal layers in eyes diagnosed with severe NPDR or PDR with or without PRP could be quantified using a ultrawide-field SS-OCTA. Eyes with PRP showed a significant decrease in choroidal thickness and vessel density of CCP and CSHL, compared with eyes without PRP. This trend was more obvious in eyes with PDR.

Application of Artificial Intelligence to Quantitative Assessment of Fundus Tessellated Density in Young Adults with Different Refractions

Introduction: The aim of this study was to quantitatively assess fundus tessellated density (FTD) and associated factors by artificial intelligence (AI) in young adults. Methods: A total of 1,084 undergraduates (age, 17–23 years old) were enrolled in November 2021. The students were divided into three groups according to axial length (AL): group 1 (AL <24.0 mm, n = 155), group 2 (24 mm ≤ AL <26 mm, n = 578), and group 3 (AL ≥26 mm, n = 269). FTD was calculated by extracting the fundus tessellations as the regions of interest (circle 1, diameter of 3.0 mm; circle 2, diameter of 6.0 mm) and then calculating the average exposed choroid area per unit area of fundus. Results: Among 1,084 students, 1,002 (92.5%) students' FTDs were extracted. The mean FTD was 0.06 ± 0.06 (range, 0–0.40). In multivariate analysis, FTD was significantly associated with male sex, longer AL, thinner subfoveal choroid thickness (SFCT), increased choriocapillaris vessel density (VD), and decreased deeper choroidal VD (all p < 0.05). In circle 1 (diameter of 3.0 mm) and circle 2 (diameter of 6.0 mm), analysis of variance showed that the FTD of the nasal region (p < 0.05) was significantly larger than that of the superior, inferior, and temporal regions. Conclusion: AI-based imaging processing could improve the accuracy of fundus tessellation diagnosis. FTD was significantly associated with a longer AL, thinner SFCT, increased choriocapillaris VD, and decreased deeper choroidal VD.

Vitrectomy in Diabetic Macular Edema:: A Swept-source OCT Angiography Study.

The foveal avascular zone (FAZ) has been reported to decrease after anti-VEGF injections in diabetic macular edema (DME) in the long term. This study aimed to present the changes in swept-source OCT angiography after vitrectomy in patients with DME. Retrospective interventional study. Thirty-five eyes were included (mean age: 62 years). Patients were followed for 12 months after vitrectomy with internal limiting membrane peeling for DME. The following parameters were measured: central retinal thickness (CRT), central choroidal thickness, superficial FAZ, deep FAZ (dFAZ), and vessel density in the superficial and deep retinal layers (dVD). The CRT and superficial FAZ significantly decreased after surgery (401 μm-338 μm; P<0.00, 401 μm-293 μm; P<0.001, respectively). Initial visual acuity (VA) improved from 20/160 (0.97 logarithm of the minimum angle of resolution [LogMAR]) to 20/80 (0.62 LogMAR) (P<0.001). The vessel density in the superficial retinal layers rate was 42.3% and decreased after surgery, reaching 41.6% at the end of the follow-up. The dVD rate 1 week after surgery was 28.9% and remained stable throughout the observation period. The most important prognostic factors for the final VA were preoperative VA and preoperative CRT, while the dFAZ and dVD at the time of edema resolution also correlated with the final VA. The superficial FAZ decreases after vitrectomy, which might indicate that vitrectomy has a protective effect on DME, similar to anti-VEGF injections. Prognostic factors for better final functional results are better initial VA and lower CRT before vitrectomy, in addition to a lower dFAZ diameter and a higher dVD at the moment of edema resolution. The author(s) have no proprietary or commercial interest in any materials discussed in this article.