Quantitative assessment of choriocapillaris flow deficits in eyes with macular neovascularization

Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1811-1819. doi: 10.1007/s00417-020-05056-1. Epub 2021 Jan 8.

Abstract

Purpose: To investigate choriocapillaris flow deficits (CC FD) in a group of eyes with Type 3 macular neovascularization (MNV) versus a group of eyes with Type 1 and/or 2 MNV versus healthy eyes.

Methods: In this cross-sectional, retrospective, multicenter, observational study, consecutive patients with Type 3 MNV, Type 1 and/or 2 MNV, and age-matched controls were included. PLEX Elite optical coherence tomography angiography was performed with a 6 × 6 mm scan pattern centered on the fovea. The CC FD was computed in 4 peripheral 1 × 1 mm squares to allow comparison between equidistant regions unaffected by MNV.

Results: Twenty Type 3, 20 Type 1 and/or 2 MNV [13 (65%) Type 1 MNV, 1 (5%) Type 2 MNV, and 6 (30%) mixed Type 1 and 2 MNV], and 20 age-matched controls were included. The mean impairment in the CC in the 4 peripheral squares was 16.07 ± 7.27% in Type 3 MNV eyes, 11.48 ± 5.59% in Type 1/2 MNV eyes, and 9.64 ± 3.59% in controls. Type 3 MNV displayed a statistically significantly higher CC FD compared with both Type 1/2 MNV (P = 0.031) and controls (P < 0.0001). No significant differences were observed between Type 1/2 MNV and controls (P = 0.223).

Conclusions: CC FD was significantly greater in the peripheral macular regions of eyes with Type 3 MNV compared to eyes with Type 1/2 MNV and normal control eyes. Pathogenic choroidal mechanisms may differ in eyes with different MNV subtypes. Whereas focal CC impairment may drive the development of Type 1/2 MNV, diffuse CC disruption may be more important in eyes with Type 3 MNV.

Keywords: Age-related macular degeneration; Choriocapillaris; Macular neovascularization; Optical coherence tomography angiography; Type 1 macular neovascularization; Type 2 macular neovascularization; Type 3 macular neovascularization.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Choroid*
  • Choroidal Neovascularization* / diagnosis
  • Cross-Sectional Studies
  • Fluorescein Angiography
  • Humans
  • Retrospective Studies
  • Tomography, Optical Coherence