Abstract
Purpose
To study the vascular density (VD) of choriocapillaris and the whole choroid using optical coherence tomography-angiography (OCTA).
Methods
Cross-sectional study enrolling healthy individuals between 18 and 35 years old and with an axial length (AL) lower than 26 mm, who were examined with swept-source OCTA Triton DRI (Topcon). Color pictures of both VD were obtained from a fovea-centered 6 × 6 mm macular exam, which were divided into 900 squares and codified into numbers.
Results
A total of 50 patients (100 eyes) with a mean age of 27.29 ± 3.90 years and a mean AL of 23.67 ± 0.74 mm were analyzed. The highest choroidal VD was found in juxtapapillary macula, being followed by the most temporal macula and fovea. The lowest was found in superior and inferior perifoveal areas. The highest VD in choriocapillaris was in the fovea. VD in this layer was uniform, with a decrease from temporal toward nasal. Both VD differed and but correlated, especially in the fovea and in inferior-temporal macula.
Conclusion
VD of choriocapillaris and the whole choroid are not similar. The former is maximal in the fovea, and the latter is maximal in the juxtapapillary macula. In general lines, choroidal VD is higher than that of choriocapillaris. Both VD are directly correlated.
Similar content being viewed by others
Availability of data and material
Data are available at the Miguel Servet University Hospital.
References
Jia Y, Tan O, Tokayer J et al (2012) Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express 20:4710–4725
Stanga PE, Tsamis E, Papayannis A et al (2016) Swept-source optical coherence tomography angioTM (Topcon Corp, Japan): technology review. In: Bandello F (ed) Developments in ophthalmology. Karger Publishers, Basel, pp 13–17
Nickla DL, Wallman J (2010) The multifunctional choroid. Prog Retin Eye Res 29:144–168. https://doi.org/10.1016/j.preteyeres.2009.12.002
Kur J, Newman EA, Chan-Ling T (2012) Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res 31:377–406. https://doi.org/10.1016/j.preteyeres.2012.04.004
Say EAT, Samara WA, Khoo CTL et al (2016) Parafoveal capillary density after plaque radiotherapy for choroidal melanoma: analysis of eyes without radiation maculopathy. Retina 36:1670–1678
Sonoda S, Sakamoto T, Yamashita T et al (2015) Luminal and stromal areas of choroid determined by binarization method of optical coherence tomographic images. Am J Ophthalmol 159:1123–1131.e1
Ruiz-Medrano J, Ruiz-Moreno JM, Goud A et al (2018) Age-related changes in choroidal vascular density of healthy subjects based on image binarization of swept-source optical coherence tomography. Retina 38:508–515
Sayanagi K, Ikuno Y, Uematsu S, Nishida K (2017) Features of the choriocapillaris in myopic maculopathy identified by optical coherence tomography angiography. Br J Ophthalmol 101:1524–1529. https://doi.org/10.1136/bjophthalmol-2016-309628
Al-Sheikh M, Phasukkijwatana N, Dolz-Marco R et al (2017) Quantitative OCT angiography of the retinal microvasculature and the choriocapillaris in myopic eyes. Investig Opthalmology Vis Sci 58:2063. https://doi.org/10.1167/iovs.16-21289
Borrelli E, Uji A, Sarraf D, Sadda SR (2017) Alterations in the choriocapillaris in intermediate age-related macular degeneration. Investig Opthalmology Vis Sci 58:4792. https://doi.org/10.1167/iovs.17-22360
Chatziralli I, Theodossiadis G, Panagiotidis D et al (2018) Choriocapillaris’ alterations in the presence of reticular pseudodrusen compared to drusen: study based on OCTA findings. Int Ophthalmol 38:1887–1893. https://doi.org/10.1007/s10792-017-0671-7
Agemy SA, Scripsema NK, Shah CM et al (2015) Retinal vascular perfusion density mapping using optical coherence tomography angiography in normals and diabetic retinopathy patients. Retina 35:2353–2363
Shinojima A, Kawamura A, Mori R et al (2016) Findings of optical coherence tomographic angiography at the choriocapillaris level in central serous chorioretinopathy. Ophthalmologica 236:108–113. https://doi.org/10.1159/000448436
Nassisi M, Lavia C, Alovisi C et al (2017) Short-term choriocapillaris changes in patients with central serous chorioretinopathy after half-dose photodynamic therapy. Int J Mol Sci 18:2468. https://doi.org/10.3390/ijms18112468
Fujita K, Kawamura A, Yuzawa M (2017) Choriocapillaris changes imaged by OCT angiography after half-dose photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retin 48:302–310. https://doi.org/10.3928/23258160-20170329-04
Cole ED, Novais EA, Louzada RN et al (2016) Visualization of changes in the choriocapillaris, choroidal vessels and retinal morphology after focal laser photocoagulation using OCT angiography. Investig Opthalmology Vis Sci 57:OCT356. https://doi.org/10.1167/iovs.15-18473
Feucht N, Maier M, Lohmann CP, Reznicek L (2016) OCT angiography findings in acute central serous chorioretinopathy. Ophthalmic Surgery, Lasers Imaging Retin 47:322–327. https://doi.org/10.3928/23258160-20160324-03
de Carlo TE, Romano A, Waheed NK, Duker JS (2015) A review of optical coherence tomography angiography (OCTA). Int J Retin Vitr 1:5
Hwang TS, Zhang M, Bhavsar K et al (2016) Visualization of 3 distinct retinal plexuses by projection-resolved optical coherence tomography angiography in diabetic retinopathy. JAMA Ophthalmol 134:1411
Chen FK, Viljoen RD, Bukowska DM (2016) Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases. Clin Experiment Ophthalmol 44:388–399. https://doi.org/10.1111/ceo.12683
Shiihara H, Sakamoto T, Yamashita T et al (2017) Reproducibility and differences in area of foveal avascular zone measured by three different optical coherence tomographic angiography instruments. Sci Rep 7:9853. https://doi.org/10.1038/s41598-017-09255-5
Munk MR, Giannakaki-Zimmermann H, Berger L et al (2017) OCT-angiography: a qualitative and quantitative comparison of 4 OCT-A devices. PLoS ONE 12:e0177059. https://doi.org/10.1371/journal.pone.0177059
Al-Sheikh M, Falavarjani KG, Pfau M et al (2017) Quantitative features of the choriocapillaris in healthy individuals using swept-source optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina 48:623–631. https://doi.org/10.3928/23258160-20170802-04
Conti FF, Qin VL, Rodrigues EB et al (2019) Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography. Br J Ophthalmol 103:452–456. https://doi.org/10.1136/bjophthalmol-2018-311903
Wang Q, Chan S, Yang JY et al (2016) Vascular density in retina and choriocapillaris as measured by optical coherence tomography angiography. Am J Ophthalmol 168:95–109. https://doi.org/10.1016/j.ajo.2016.05.005
Oh J, Baik DJ, Ahn J (2020) Inter-relationship between retinal and choroidal vasculatures using optical coherence tomography angiography in normal eyes. Eur J Ophthalmol 1:48–57
Sohn EH, Khanna A, Tucker BA et al (2014) Structural and biochemical analyses of choroidal thickness in human donor eyes. Invest Ophthalmol Vis Sci 55:1352–1360. https://doi.org/10.1167/iovs.13-13754
Macgregor AM, Eberhart CG, Fraig M et al (2009) Tissue inhibitor of matrix metalloproteinase-3 levels in the extracellular matrix of lung, kidney, and eye increase with age. J Histochem Cytochem 57:207–213. https://doi.org/10.1369/jhc.2008.952531
Fariss RN, Apte SS, Luthert PJ et al (1998) Accumulation of tissue inhibitor of metalloproteinases-3 in human eyes with Sorsby’s fundus dystrophy or retinitis pigmentosa. Br J Ophthalmol 82:1329–1334
Janssen A, Hoellenriegel J, Fogarasi M et al (2008) Abnormal vessel formation in the choroid of mice lacking tissue inhibitor of metalloprotease-3. Investig Opthalmology Vis Sci 49:2812. https://doi.org/10.1167/iovs.07-1444
Funding
No funding was received.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval
Ethics approval by the Comité de Ética de la Investigación de la Comunidad Autónoma de Aragón.
Consent to participate
All patients agreed to participate.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bartol-Puyal, F., Isanta, C., Calvo, P. et al. Relationship between vascular densities of choriocapillaris and the whole choroid using OCTA. Int Ophthalmol 40, 3135–3143 (2020). https://doi.org/10.1007/s10792-020-01500-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-020-01500-7