Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography

Cathrine M Keiner,1 Hao Zhou,2 Qinqin Zhang,2 Ruikang K Wang,2 Nicholas T Rinella,1 Catherine E Oldenburg,1,3 Jacque L Duncan,1 Daniel M Schwartz11Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Department of Bioengineering, University of Washington, Seattle, WA, USA;...

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Autores principales:	Keiner CM, Zhou H, Zhang Q, Wang RK, Rinella NT, Oldenburg CE, Duncan JL, Schwartz DM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Flow void AMD OCT angiography OCTA Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/7afc492592bc4a12b747ae8a8e033fff
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spelling	oai:doaj.org-article:7afc492592bc4a12b747ae8a8e033fff2021-12-02T04:27:23ZQuantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography1177-5483https://doaj.org/article/7afc492592bc4a12b747ae8a8e033fff2019-08-01T00:00:00Zhttps://www.dovepress.com/quantifying-choriocapillaris-hypoperfusion-in-patients-with-choroidal--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Cathrine M Keiner,1 Hao Zhou,2 Qinqin Zhang,2 Ruikang K Wang,2 Nicholas T Rinella,1 Catherine E Oldenburg,1,3 Jacque L Duncan,1 Daniel M Schwartz11Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Department of Bioengineering, University of Washington, Seattle, WA, USA; 3Francis I. Proctor Foundation, University of California, San Francisco, CA, USACorrespondence: Daniel M SchwartzDepartment of Ophthalmology, University of California, 10 Koret Way, San Francisco, CA 94117, USATel +1 415 476 1152Email dan.schwartz@ucsf.eduPurpose: To compare choriocapillaris flow voids (FV) in patients with neovascular age-related macular degeneration (AMD) with age-matched normal controls using swept-source optical coherence tomography angiography (SS-OCTA).Patients and methods: Eleven eyes of 11 subjects with neovascular AMD and 11 eyes of 11 age-similar normal subjects were imaged using SS-OCTA with a 6x6mm scanning pattern. Choriocapillaris FV, defined as a percentage of regions determined to have flow deficits divided by the total scanned region, was measured using a one standard deviation thresholding algorithm developed from a database of age-similar normal subjects.Results: Choriocapillaris FV was more extensive in patients with choroidal neovascularization (CNV) compared to age-similar normal subjects (FV: 20.56±4.95, 95% CI: 17.64–23.49 vs FV: 10.95±2.08, 95% CI: 9.73–12.18, respectively; P=0.0001). FV within a two-degree margin surrounding CNV in wet AMD subjects (FV: 35.04±9.34; 95% CI: 29.52–40.56) was increased compared to normal subjects (P<0.001). FV of the region outside the two-degree margin surrounding CNV (FV: 19.61±6.08, 95% CI: 16.02–23.20) was increased compared to age-similar controls (P=0.0002). In neovascular AMD eyes, FV was greater within two degrees of the margin of CNV than in the remainder of the macula (margin: 35.04±9.34; outside: 19.61±6.08; P=0.002), and CNV lesion area was positively correlated with FV (correlation coefficient =0.84; 95% CI: 0.49–0.96; P=0.001).Conclusion: Choriocapillaris flow deficits were significantly greater in wet AMD subjects than age-similar normal subjects, suggesting that choroidal hypo-perfusion likely plays a role in the pathogenesis of neovascular AMD. Recognition of choriocapillaris flow deficits in patients with AMD may facilitate earlier diagnosis and identify alternative therapeutic targets for this multifactorial disease.Keywords: flow void, AMD, OCT angiography, OCTAKeiner CMZhou HZhang QWang RKRinella NTOldenburg CEDuncan JLSchwartz DMDove Medical PressarticleFlow voidAMDOCT angiographyOCTAOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1613-1620 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Flow void AMD OCT angiography OCTA Ophthalmology RE1-994
spellingShingle	Flow void AMD OCT angiography OCTA Ophthalmology RE1-994 Keiner CM Zhou H Zhang Q Wang RK Rinella NT Oldenburg CE Duncan JL Schwartz DM Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
description	Cathrine M Keiner,1 Hao Zhou,2 Qinqin Zhang,2 Ruikang K Wang,2 Nicholas T Rinella,1 Catherine E Oldenburg,1,3 Jacque L Duncan,1 Daniel M Schwartz11Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Department of Bioengineering, University of Washington, Seattle, WA, USA; 3Francis I. Proctor Foundation, University of California, San Francisco, CA, USACorrespondence: Daniel M SchwartzDepartment of Ophthalmology, University of California, 10 Koret Way, San Francisco, CA 94117, USATel +1 415 476 1152Email dan.schwartz@ucsf.eduPurpose: To compare choriocapillaris flow voids (FV) in patients with neovascular age-related macular degeneration (AMD) with age-matched normal controls using swept-source optical coherence tomography angiography (SS-OCTA).Patients and methods: Eleven eyes of 11 subjects with neovascular AMD and 11 eyes of 11 age-similar normal subjects were imaged using SS-OCTA with a 6x6mm scanning pattern. Choriocapillaris FV, defined as a percentage of regions determined to have flow deficits divided by the total scanned region, was measured using a one standard deviation thresholding algorithm developed from a database of age-similar normal subjects.Results: Choriocapillaris FV was more extensive in patients with choroidal neovascularization (CNV) compared to age-similar normal subjects (FV: 20.56±4.95, 95% CI: 17.64–23.49 vs FV: 10.95±2.08, 95% CI: 9.73–12.18, respectively; P=0.0001). FV within a two-degree margin surrounding CNV in wet AMD subjects (FV: 35.04±9.34; 95% CI: 29.52–40.56) was increased compared to normal subjects (P<0.001). FV of the region outside the two-degree margin surrounding CNV (FV: 19.61±6.08, 95% CI: 16.02–23.20) was increased compared to age-similar controls (P=0.0002). In neovascular AMD eyes, FV was greater within two degrees of the margin of CNV than in the remainder of the macula (margin: 35.04±9.34; outside: 19.61±6.08; P=0.002), and CNV lesion area was positively correlated with FV (correlation coefficient =0.84; 95% CI: 0.49–0.96; P=0.001).Conclusion: Choriocapillaris flow deficits were significantly greater in wet AMD subjects than age-similar normal subjects, suggesting that choroidal hypo-perfusion likely plays a role in the pathogenesis of neovascular AMD. Recognition of choriocapillaris flow deficits in patients with AMD may facilitate earlier diagnosis and identify alternative therapeutic targets for this multifactorial disease.Keywords: flow void, AMD, OCT angiography, OCTA
format	article
author	Keiner CM Zhou H Zhang Q Wang RK Rinella NT Oldenburg CE Duncan JL Schwartz DM
author_facet	Keiner CM Zhou H Zhang Q Wang RK Rinella NT Oldenburg CE Duncan JL Schwartz DM
author_sort	Keiner CM
title	Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
title_short	Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
title_full	Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
title_fullStr	Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
title_full_unstemmed	Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography
title_sort	quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source oct angiography
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/7afc492592bc4a12b747ae8a8e033fff
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Quantifying choriocapillaris hypoperfusion in patients with choroidal neovascularization using swept-source OCT angiography

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