Choroidal Venous Architecture and Polypoidal Lesion Distribution in PCV Subtypes Revealed by UWF Full-Range SS-OCTA

Research published in Translational Vision Science & Technology investigates the spatial relationships among choroidal vortex veins (VVs), choroidal watershed zones (CWZs), and polypoidal lesion distribution across different subtypes of polypoidal choroidal vasculopathy (PCV). These subtypes were categorized according to choroidal vascular hyperpermeability (CVH) status using ultra-widefield (UWF) imaging.

In this study, eyes with PCV exhibited a greater number of dominant VVs on the temporal side, and the majority of polypoidal lesions were located within regions supplied by these dominant VVs. This finding demonstrates a strong correlation between lesion distribution and dominant vortex veins.

The results also revealed significantly higher values of subfoveal choroidal thickness (SFCT), three-dimensional choroidal vascularity index (3D CVI), and choroidal vascular volume per area (CVV/a) when comparing PCV eyes with and without CVH. In addition, PCV eyes with CVH exhibited a significantly higher prevalence of type 2 macular neovascularization (MNV).

Notably, the CVH group showed a significantly higher proportion of lesions located within CWZs compared with the non-CVH group. This suggests that CVH may exacerbate the pathological microenvironment in CWZs, rendering these regions more susceptible to vascular damage and lesion formation.

A 400 kHz swept-source OCTA system (BMizar, TowardPi Medical) was used in this study to visualize UWF choroidal images and quantify three-dimensional choroidal parameters using built-in software. This approach provides valuable insights into choroidal venous architecture and CVH-driven pathological changes that may contribute to the pathogenesis of PCV.

This research was authored by Dr. Yining Zhang and colleagues from the team of Professor Feng Wen at Zhongshan Ophthalmic Center, Sun Yat-Sen University.

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