Choroidal vascularity index and choriocapillary changes in retinal vein occlusions
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RETINAL DISORDERS
Choroidal vascularity index and choriocapillary changes in retinal vein occlusions Yavuz Kemal Aribas 1 & Ahmet M. Hondur 1
&
Tongalp H. Tezel 2
Received: 28 April 2020 / Revised: 18 July 2020 / Accepted: 6 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 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. Keywords Choriocapillaris flow density . Choroidal vascularity index . Enhanced depth imaging . Haller layer/choroidal thickness ratio . Optical coherence tomography angiography . Retinal vein occlusion
Introduction Changes in the choroid preceding or accompanying age-related macular degeneration, central serous chorioretinopathy, and diabetic retinopathy have been reported [1–3]. However, the study of the choroid in retinal vein occlusions (RVO) has been limited to conflicting alterations in the subfoveal choroid thickness and choriocapillaris flow [4–7]. The development of new imaging technologies has allowed clinicians to study the structural features of the choroid in a more precise way. Particularly, enhanced depth imaging (EDI) with the optical coherence tomography (OCT) and choriocapillaris flow density estimations with the OCT-angiography (OCT-A) * Ahmet M. Hondur [email protected] 1
Department of Ophthalmology, Gazi University, Ankara, Turkey
2
Edward Harkness Institute of Ophthalmology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
allow clinicians to segment and analyze choroidal layers and obtain an idea about its functional status. In this study, we investigated the choroidal changes in the setting of retinal vein occlusion using the choroidal vascularity index (CVI), the Haller layer/choroidal thickness (H/C) ratio, and the chorioc
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