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Choroidal Round Hyporeflectivities in Geographic Atrophy

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A).

Methods: Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed.

Results: Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01).

Conclusions: Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

No MeSH data available.


Related in: MedlinePlus

Optical coherence tomography angiography (OCT-A) and spectral domain optical coherence tomography (SD-OCT) at 6 months follow-up visit in the right eye of a patient (previous examination reported in Fig 1) with hyporeflective round areas.Choroidal segmentation on 3x3 OCT-A (first row, first panel) / en face imaging (first row, second panel), structural SD-OCT B-scan with (first row, third panel) and without flow analysis (second row, first panel) reveal no changes in size and shape six months after hyporeflective round areas identification.
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pone.0166968.g003: Optical coherence tomography angiography (OCT-A) and spectral domain optical coherence tomography (SD-OCT) at 6 months follow-up visit in the right eye of a patient (previous examination reported in Fig 1) with hyporeflective round areas.Choroidal segmentation on 3x3 OCT-A (first row, first panel) / en face imaging (first row, second panel), structural SD-OCT B-scan with (first row, third panel) and without flow analysis (second row, first panel) reveal no changes in size and shape six months after hyporeflective round areas identification.

Mentions: In all cases, the round hyporeflectivities were clearly hypofluorescent in late phase ICGA (Figs 1 and 2), and all 29 areas (21 eyes) appeared as dark foci with non detectable flow in the choroidal segmentation of OCT-A (Figs 1 and 2). Interestingly, for some hyporeflectivities (8 in 7 out of 21 eyes) it was possible to distinguish a hyporeflective sinusoidal tract in the sclera. Among the 21 eyes presenting round hyporeflectivities, structural OCT B-scans and OCT-A follow-up was available in 18 eyes (86%) of 13 patients. Mean follow-up was 5.8±1.7 months (median, 6; range, 2–8 months). Interestingly, all choroidal round lesions did not change in size, shape and anatomical location as shown in Figs 3 and 4.


Choroidal Round Hyporeflectivities in Geographic Atrophy
Optical coherence tomography angiography (OCT-A) and spectral domain optical coherence tomography (SD-OCT) at 6 months follow-up visit in the right eye of a patient (previous examination reported in Fig 1) with hyporeflective round areas.Choroidal segmentation on 3x3 OCT-A (first row, first panel) / en face imaging (first row, second panel), structural SD-OCT B-scan with (first row, third panel) and without flow analysis (second row, first panel) reveal no changes in size and shape six months after hyporeflective round areas identification.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120831&req=5

pone.0166968.g003: Optical coherence tomography angiography (OCT-A) and spectral domain optical coherence tomography (SD-OCT) at 6 months follow-up visit in the right eye of a patient (previous examination reported in Fig 1) with hyporeflective round areas.Choroidal segmentation on 3x3 OCT-A (first row, first panel) / en face imaging (first row, second panel), structural SD-OCT B-scan with (first row, third panel) and without flow analysis (second row, first panel) reveal no changes in size and shape six months after hyporeflective round areas identification.
Mentions: In all cases, the round hyporeflectivities were clearly hypofluorescent in late phase ICGA (Figs 1 and 2), and all 29 areas (21 eyes) appeared as dark foci with non detectable flow in the choroidal segmentation of OCT-A (Figs 1 and 2). Interestingly, for some hyporeflectivities (8 in 7 out of 21 eyes) it was possible to distinguish a hyporeflective sinusoidal tract in the sclera. Among the 21 eyes presenting round hyporeflectivities, structural OCT B-scans and OCT-A follow-up was available in 18 eyes (86%) of 13 patients. Mean follow-up was 5.8±1.7 months (median, 6; range, 2–8 months). Interestingly, all choroidal round lesions did not change in size, shape and anatomical location as shown in Figs 3 and 4.

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A).

Methods: Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed.

Results: Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01).

Conclusions: Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

No MeSH data available.


Related in: MedlinePlus