Investigating the choriocapillaris and choroidal vasculature with new optical coherence tomography technologies
Section snippets
Basic histology of the choroid in normal eyes
The morphological features of the Bruch membrane/choriocapillaris complex and choroidal vasculature on ex-vivo histology, described herein, are relevant for the proper interpretation of the optical reconstruction of the tissue through in vivo fundus imaging.
Basic principles of Fourier domain optical coherence tomography
Optical coherence tomography is based on the physical principle of interferometry; a Michaelson interferometer uses the wavelength of the light as its own timing standard. The micron-scale resolution is obtained by comparison between the time of flight of the sample reflection and the known time of delay of a reference reflection, by looking for phase differences in the light interference. Coherence of light is conceptualized as a measure of how two waves of light are correlated to each other
Total choroidal thickness
Technological advances on Fourier domain OCT that took place in the last few years, including acquisition techniques and post-acquisition processing methods, greatly contributed to a better visualization of deeper structures such as the choroid on cross-sectional OCT. The total choroidal thickness could be more precisely assessed, either at the subfoveal region or throughout the length of the cross-sectional scan, because the choroidal-scleral interface became easier to identify (Adhi et al.,
Typical age-related macular degeneration
Studies with cross-sectional OCT show somewhat discordant results related to subfoveal total choroidal thickness measurements in AMD. Discrepant results may be related to wide variability of choroidal morphology in the population, as well as to limitations of quantitative and qualitative assessment of the choroid on cross-sectional OCT. In addition, discordance across studies may be related to different disease stages and specific clinical features, such as the sub-type of choroidal
Future directions
Tridimensional, dense volumetric datasets acquired with faster and deeper OCT scans are currently a valuable tool to investigate the posterior segment of the eye, from the vitreous cavity to the choroidal scleral interface. New advances on OCT have dramatically increased our understanding of the morphology and function of chorioretinal tissues. Emerging advances on spectral domain OCT and swept source OCT, including en face OCT and OCT angiography, are definitive game changers in the research
Conflicts of interest
Jay S. Duker receives research support from Carl Zeiss Meditech, Inc. and Optovue, Inc. Daniela Ferrara is an employee at Genentech, Inc. and receives stock/stock options from Roche.
Acknowledgments
We acknowledge support from NIH (R01-EY011289-27, R01-EY013178-12, R01-EY018184-05, R44EY022864-01, R01-CA075289-16, R01-NS057476-05, R44-EY022864-01); AFOSR (FA9550-10-1-0551 and FA9550-10-1-0063); Massachusetts Lions Club; German Science Foundation DFG (DFG-GSC80-SAOT). The funding organizations had no role in the design or conduct of this research.
References (288)
- et al.
The other CNVM: a review of myopic choroidal neovascularization treatment in the age of anti-vascular endothelial growth factors agents
Surv. Ophthalmol.
(2015) - et al.
Analysis of choroidal thickness in eyes treated with focal laser photocoagulation using SD-OCT
Can. J. Ophthalmol.
(2013) - et al.
A role for local inflammation in the formation of drusen in the aging eye
Am. J. Ophthalmol.
(2002) - et al.
The pivotal role of the complement system in aging and age-related macular degeneration: hypothesis re-visited
(2010) - et al.
Choroidal volume variations with age, axial length, and sex in healthy subjects: a three-dimensional analysis
Ophthalmology
(2012) - et al.
Spectral domain optical coherence tomography imaging of geographic atrophy margins
Ophthalmology
(2009) - et al.
Understanding age-related macular degeneration (AMD): relatioships between the photoreceptor/retinal pigment epithelium/Bruch membrane/choriocapillaris complex
Mol. Asp. Med.
(2012) - et al.
Polarized vascular endothelial growth factor secretion by human retinal pigment epithelium and localized vascular endothelial growth factor receptors on the inner choriocapillaris. Evidence for a trophic paracrine relation
Am. J. Pathol.
(1999) - et al.
Reproducibility of choroidal thickness measurements across three spectral domain optical coherence tomography systems
Ophthalmology
(2012) - et al.
Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography
Ophthalmology
(2013)
Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration
Ophthalmology
The role of aging, high fat diet and blue light exposure in an experimental mouse model for basal laminar deposit formation
Exp. Eye Res.
Spectral-domain optical coherence tomography angiography of choroidal neovascularization
Ophthalmology
Risk factors for age-related macular degeneration
Prog. Retin Eye Res.
Age-related macular changes in humans over 90 years old
Am. J. Ophthalmol.
En face enhanced-depth swept-source optical coherence tomography features of chronic central serous chorioretinopathy
Ophthalmology
Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes
Am. J. Ophthalmol.
Effects of extracellular matrix and neighboring cells on induction of human embryonic stem cells into retinal pigment epithelial progenitors
Exp. Eye Res.
An integrated hypothesis that considers drusen as biomarkers of immune-mediated processes at the RPE-Bruch membrane interface in aging and age-related macular degeneration
Prog. Retin Eye Res.
Diabetic choroidopathy. Light and electron microscopic obervations of seven cases
Ophthalmology
Analysis of normal peripapillary choroidal thickness via spectral domain optical coherence tomography
Ophthalmology
Optical coherence tomography – current and future applications
Curr. Opin. Ophthalmol.
Analysis of morphological features and vascular layers of choroid in diabetic retinopathy using spectral-domain optical coherence tomography
JAMA Ophthalmol.
Enhanced visualization of the choroido-scleral interface using swept-source OCT
Ophthalmic Surg. Lasers Imaging Retina
Choroidal analysis in healthy eyes using swept-spirce optical coherence tomography compared to spectral domain optical coherence tomography
Am. J. Ophthalmol.
Characterization of choroidal layers in normal aging eyes using enface swept-source optical coherence tomography
PLoS One
Choroidal thickness measurement in healthy Japanese subjects by three-dimensional high-penetration optical coherence tomography
Graefes Arch. Clin. Exp. Ophthalmol.
En face imaging of the choroid in polypoidal choroidal vasculopathy using swept-source optical coherence tomography
Am. J. Ophthalmol.
Ocular and optic nerve blood flow at normal and increased intraocular pressures in monkeys (Macaca irus): a study with radioactively labelled microspheres including flow determinations in brain and someother tissues
Exp. Eye Res.
Reproducibility-repeatability of choroidal thickness calculation using optical coherence tomography
Optom. Vis. Sci.
The ophthalmic innervation of the uvea in monkeys
Exp. Eye Res.
Classification of abnormal fundus autofluorescence patterns in the junctional zone of geographic atrophy in patients with age-related macular degeneration
Br. J. Ophthalmol.
Therapeutic targets in age-related macular disease
J. Clin. Invest
Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography
JAMA Ophthalmol.
Differential expression of the complement regulatory proteins in the human eye
Invest Ophthalmol. Vis. Sci.
Choroidal thickness measurements during central serous chorioretinopathy treatment
Int. Ophthalmol.
Quantification of erythrocyte flow in the choroid of the albino rat
Am. J. Physiol.
Wolff's Anatomy of the Eye and Orbit
In vivo human choroidal thickness measurements: evidence for diurnal fluctuations
Invest Ophthalmol. Vis. Sci.
Recent developments in the management of dry-age related macular degeneration
Clin. Ophthalmol.
Morphologic characterization of dome-shaped macula in myopic eyes with serous macular detachment
Am. J. Ophthalmol.
Wide-field spectral domain-optical coherence tomography in central serous chorioretinopathy
Int. Ophthalmol.
Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics
Invest Ophthalmol. Vis. Sci.
How can we prevent myopia progression?
Eur. J. Ophthalmol.
Automated choroid segmentation based on gradual intensity distance in HD-OCT images
Opt. Express
Optical coherence tomography using a frequency-tunable optical source
Opt. Lett.
Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography
PLoS One
Sensitivity advantage of swept source and Fourier domain optical coherence tomography
Opt. Express
Optical coherence tomography and pathological myopia: an update of the literature
Int. Ophthalmol
Direct comparison of spectral-domain and swept-source OCT in the measurement of choroidal thickness in normal eyes
Br. J. Ophthalmol.
Cited by (219)
Visualization of choroidal vasculature in pigmented mouse eyes from experimental models of AMD
2024, Experimental Eye ResearchCo-assessment of OCT-A and choroidal vascularity index data in multiple sclerosis patients
2023, Photodiagnosis and Photodynamic TherapyInvestigation of Retinal Vascular Parameters and Choroidal Vascular Index in Patients Developing Hyphema After Unilateral Blunt Trauma
2023, Photodiagnosis and Photodynamic TherapyRelationship between macular intervortex vein anastomosis and optical coherence tomography biomarkers in chronic central serous chorioretinopathy
2023, Photodiagnosis and Photodynamic TherapyThe association between decreased choriocapillary flow and electroretinogram impairments in patients with diabetes
2023, Photodiagnosis and Photodynamic TherapyChoriocapillaris Flow Deficit as a Biomarker for Diabetic Retinopathy and Diabetic Macular Edema: 3-Year Longitudinal Cohort
2023, American Journal of Ophthalmology