Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-11-2020 | Angiography | Retinal Disorders

Choroidal vascularity index and choriocapillary changes in retinal vein occlusions

Authors: Yavuz Kemal Aribas, Ahmet M. Hondur, Tongalp H. Tezel

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 11/2020

Abstract

Purpose

To evaluate the changes in the choroidal structure in the setting of retinal vein occlusion (RVO).

Methods

Changes in the structure of the choroid were studied in sixty-four eyes with unilateral central or branch RVO using optical coherence tomography (OCT) with enhanced depth imaging and OCT-angiography (OCT-A). Choroidal vascularity index (CVI), Haller layer/choroidal thickness (H/C) ratio, and choriocapillaris flow density were used to compare the structural characteristics of the choroid with fellow eyes and the eyes of thirty-four age-, gender-, and systemic co-morbidity–matched controls.

Results

Eyes with RVO had a higher H/C ratio but a lower choriocapillaris flow density compared to both fellow and control eyes (p < 0.001). CVI was significantly lower in both eyes of the patients with RVO compared with control eyes (p < 0.05) with a more robust decrease in the eye that had developed RVO (p < 0.001). The H/C ratio (r = 0.303 p < 0.001), CVI (r = − 0.268, p = 0.001), and choriocapillaris flow density (r = − 0.237, p = 0.003) were all correlated with logMAR visual acuity, and other clinical features.

Conclusion

Retinal vein occlusions alter the hemodynamic properties of the choroid leading to structural changes. These changes may be secondary to a compensatory mechanism to supply oxygen to hypoxic retina.

Keenan TD, Klein B, Agron E, Chew EY, Cukras CA, Wong WT (2020) Choroidal thickness and vascularity vary with disease severity and subretinal drusenoid deposit presence in nonadvanced age-related macular degeneration. Retina. https://doi.org/10.1097/iae.0000000000002434

Kim M, Ha MJ, Choi SY, Park Y-H (2018) Choroidal vascularity index in type-2 diabetes analyzed by swept-source optical coherence tomography. Sci Rep 8(1):70. https://doi.org/10.1038/s41598-017-18511-7CrossRefPubMedPubMedCentral

Agrawal R, Chhablani J, Tan KA, Shah S, Sarvaiya C, Banker A (2016) Choroidal vascularity index in central serous chorioretinopathy. Retina 36(9):1646–1651. https://doi.org/10.1097/iae.0000000000001040CrossRefPubMed

Rayess N, Rahimy E, Ying GS, Pefkianaki M, Franklin J, Regillo CD, Ho AC, Hsu J (2016) Baseline choroidal thickness as a predictor for treatment outcomes in central retinal vein occlusion. Am J Ophthalmol 171:47–52. https://doi.org/10.1016/j.ajo.2016.08.026CrossRefPubMed

Khodabandeh A, Shahraki K, Roohipoor R, Riazi-Esfahani H, Yaseri M, Faghihi H, Bazvand F (2018) Quantitative measurement of vascular density and flow using optical coherence tomography angiography (OCTA) in patients with central retinal vein occlusion: can OCTA help in distinguishing ischemic from non-ischemic type? Int J Retin Vitreous 4:47–47. https://doi.org/10.1186/s40942-018-0152-9CrossRef

Mastropasqua R, Toto L, Di Antonio L, Borrelli E, Senatore A, Di Nicola M, Di Martino G, Ciancaglini M, Carpineto P (2017) Optical coherence tomography angiography microvascular findings in macular edema due to central and branch retinal vein occlusions. Sci Rep 7:40763. https://doi.org/10.1038/srep40763CrossRefPubMed

Du KF, Xu L, Shao L, Chen CX, Zhou JQ, Wang YX, You QS, Jonas JB, Wei WB (2013) Subfoveal choroidal thickness in retinal vein occlusion. Ophthalmology 120(12):2749–2750. https://doi.org/10.1016/j.ophtha.2013.08.031CrossRefPubMed

Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D, Wu SY (1993) The lens opacities classification system III. The longitudinal study of cataract study group. Arch Ophthalmol 111(6):831–836. https://doi.org/10.1001/archopht.1993.01090060119035CrossRefPubMed

Chung YR, Kim JW, Choi SY, Park SW, Kim JH, Lee K (2018) Subfoveal choroidal thickness and vascular diameter in active and resolved central serous chorioretinopathy. Retina 38(1):102–107. https://doi.org/10.1097/iae.0000000000001502CrossRefPubMed

10.

Sonoda S, Sakamoto T, Yamashita T, Shirasawa M, Uchino E, Terasaki H, Tomita M (2014) Choroidal structure in normal eyes and after photodynamic therapy determined by Binarization of optical coherence tomographic ImagesBinarization of OCT on choroid. Invest Ophthalmol Vis Sci 55(6):3893–3899. https://doi.org/10.1167/iovs.14-14447CrossRefPubMed

11.

Mrejen S, Spaide RF (2013) Optical coherence tomography: imaging of the choroid and beyond. Surv Ophthalmol 58(5):387–429. https://doi.org/10.1016/j.survophthal.2012.12.001CrossRefPubMed

12.

Shao Z, Dorfman AL, Seshadri S, Djavari M, Kermorvant-Duchemin E, Sennlaub F, Blais M, Polosa A, Varma DR, Joyal JS, Lachapelle P, Hardy P, Sitaras N, Picard E, Mancini J, Sapieha P, Chemtob S (2011) Choroidal involution is a key component of oxygen-induced retinopathy. Invest Ophthalmol Vis Sci 52(9):6238–6248. https://doi.org/10.1167/iovs.10-6742CrossRefPubMed

13.

Lutty GA, Otsuji T, Taomoto M, Merges C, McLeod DS, Kim SY, Vanderslice P, Suzuka S, Fabry ME, Nagel RL (2002) Mechanisms for sickle red blood cell retention in choroid. Curr Eye Res 25(3):163–171. https://doi.org/10.1076/ceyr.25.3.163.13481CrossRefPubMed

14.

Gallice M, Zhou T, Aptel F, Verges S, Riva C, Geiser M, Chiquet C (2017) Hypoxic, hypercapnic, and hyperoxic responses of the optic nerve head and subfoveal choroid blood flow in healthy humans. Invest Ophthalmol Vis Sci 58(12):5460–5467. https://doi.org/10.1167/iovs.17-21855CrossRefPubMed

15.

Tsuiki E, Suzuma K, Ueki R, Maekawa Y, Kitaoka T (2013) Enhanced depth imaging optical coherence tomography of the choroid in central retinal vein occlusion. Am J Ophthalmol 156(3):543–547.e541. https://doi.org/10.1016/j.ajo.2013.04.008CrossRefPubMed

16.

Wei WB, Xu L, Jonas JB, Shao L, Du KF, Wang S, Chen CX, Xu J, Wang YX, Zhou JQ, You QS (2013) Subfoveal choroidal thickness: the Beijing eye study. Ophthalmology 120(1):175–180. https://doi.org/10.1016/j.ophtha.2012.07.048CrossRefPubMed

17.

Lee EK, Han JM, Hyon JY, Yu HG (2015) Changes in choroidal thickness after intravitreal dexamethasone implant injection in retinal vein occlusion. Br J Ophthalmol 99(11):1543–1549. https://doi.org/10.1136/bjophthalmol-2014-306417CrossRefPubMed

18.

Johnson M, McLaren JW, Overby DR (2017) Unconventional aqueous humor outflow: a review. Exp Eye Res 158:94–111. https://doi.org/10.1016/j.exer.2016.01.017CrossRefPubMed

19.

Hollborn M, Rehak M, Iandiev I, Pannicke T, Ulbricht E, Reichenbach A, Wiedemann P, Bringmann A, Kohen L (2012) Transcriptional regulation of aquaporins in the ischemic rat retina: upregulation of aquaporin-9. Curr Eye Res 37(6):524–531. https://doi.org/10.3109/02713683.2012.658133CrossRefPubMed

20.

Schroder K, Ackermann P, Brachert M, Bairov S, Geerling G, Guthoff R (2016) Does OCT morphology provide indications for prognosis of visual acuity after venous occlusion? : SD-OCT analysis in retinal vein occlusion before and after resolution of initial macular edema. Ophthalmologe 113(6):500–506. https://doi.org/10.1007/s00347-016-0234-8CrossRefPubMed

21.

Costanzo E, Parravano M, Gilardi M, Cavalleri M, Sacconi R, Aragona E, Varano M, Bandello F, Querques G (2019) Microvascular retinal and choroidal changes in retinal vein occlusion analyzed by two different optical coherence tomography angiography devices. Ophthalmologica 242(1):8–15. https://doi.org/10.1159/000496195CrossRefPubMed

22.

Saint-Geniez M, Kurihara T, Sekiyama E, Maldonado AE, D'Amore PA (2009) An essential role for RPE-derived soluble VEGF in the maintenance of the choriocapillaris. Proc Natl Acad Sci U S A 106(44):18751–18756. https://doi.org/10.1073/pnas.0905010106CrossRefPubMedPubMedCentral

23.

Marneros AG, Fan J, Yokoyama Y, Gerber HP, Ferrara N, Crouch RK, Olsen BR (2005) Vascular endothelial growth factor expression in the retinal pigment epithelium is essential for choriocapillaris development and visual function. Am J Pathol 167(5):1451–1459. https://doi.org/10.1016/s0002-9440(10)61231-xCrossRefPubMedPubMedCentral

24.

Julien S, Biesemeier A, Taubitz T, Schraermeyer U (2014) Different effects of intravitreally injected ranibizumab and aflibercept on retinal and choroidal tissues of monkey eyes. Br J Ophthalmol 98(6):813–825. https://doi.org/10.1136/bjophthalmol-2013-304019CrossRefPubMed

25.

Woo SC, Lip GY, Lip PL (2016) Associations of retinal artery occlusion and retinal vein occlusion to mortality, stroke, and myocardial infarction: a systematic review. Eye (Lond) 30(8):1031–1038. https://doi.org/10.1038/eye.2016.111CrossRef

26.

Chen YY, Yen YF, Lin JX, Feng SC, Wei LC, Lai YJ, Shen YC (2018) Risk of ischemic stroke, hemorrhagic stroke, and all-cause mortality in retinal vein occlusion: a nationwide population-based cohort study. J Ophthalmol 2018:8629429. https://doi.org/10.1155/2018/8629429CrossRefPubMedPubMedCentral

27.

Wu CY, Riangwiwat T, Limpruttidham N, Rattanawong P, Rosen RB, Deobhakta A (2019) Association of retinal vein occlusion with cardiovascular events and mortality: a systematic review and meta-analysis. Retina 39(9):1635–1645. https://doi.org/10.1097/iae.0000000000002472CrossRefPubMed

28.

Chua J, Chin CWL, Tan B, Wong SH, Devarajan K, Le TT, Ang M, Wong TY, Schmetterer L (2019) Impact of systemic vascular risk factors on the choriocapillaris using optical coherence tomography angiography in patients with systemic hypertension. Sci Rep 9(1):5819. https://doi.org/10.1038/s41598-019-41917-4CrossRefPubMedPubMedCentral

29.

Ayhan Z, Kaya M, Ozturk T, Karti O, Oner FH (2017) Evaluation of macular perfusion in healthy smokers by using optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina 48(8):617–622. https://doi.org/10.3928/23258160-20170802-03CrossRefPubMed

30.

Okamoto M, Yamashita M, Sakamoto T, Ogata N (2018) Choroidal blood flow and thickness as predictors for response to anti-vascular endothelial growth factor therapy in macular edema secondary to branch retinal vein occlusion. Retina 38(3):550–558. https://doi.org/10.1097/iae.0000000000001566CrossRefPubMed

Title: Choroidal vascularity index and choriocapillary changes in retinal vein occlusions
Authors: Yavuz Kemal Aribas
Ahmet M. Hondur
Tongalp H. Tezel
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keyword: Angiography
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 11/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-020-04886-3

ACC 2024 Congress

Springer Medicine

Choroidal vascularity index and choriocapillary changes in retinal vein occlusions

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2020

Acute acquired concomitant esotropia associated with myopia: is the condition related to any binocular function failure?

Prediction of visual field from swept-source optical coherence tomography using deep learning algorithms

Evaluation of retinal vessel density and choriocapillaris flow in migraine patients with and without aura

Choriocapillaris flow deficit associated with intraretinal hyperreflective foci in intermediate age-related macular degeneration

Multicolor imaging in macular telangiectasia—a comparison with fundus autofluorescence

Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak