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Choroidal Round Hyporeflectivities in Geographic Atrophy.

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New findings reveal that round hyporeflectivities beneath geographic atrophy (GA) on optical coherence tomography (OCT) likely represent non-perfused choroidal vessels. This discovery aids in understanding GA progression and potential treatment targets.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • Geographic atrophy (GA) is an advanced form of age-related macular degeneration.
  • Choroidal vessels in GA typically appear as hyperreflective on structural optical coherence tomography (OCT).
  • Novel observation of hyporeflective choroidal findings beneath GA warrants further investigation.

Purpose of the Study:

  • To investigate the characteristics of choroidal round hyporeflectivities with reflective borders observed beneath geographic atrophy (GA).
  • To compare findings from structural OCT, indocyanine green angiography (ICGA), and OCT angiography (OCT-A) in patients with GA.

Main Methods:

  • Analysis of patients with GA secondary to non-neovascular age-related macular degeneration.
  • Utilized structural OCT, ICGA, and OCT-A for imaging and analysis.
  • Correlated choroidal round hyporeflectivities beneath GA on OCT with ICGA and OCT-A findings.

Main Results:

  • Twenty-nine round hyporeflectivities were identified in 21 of 50 eyes (42.0%) from 26 patients.
  • These hyporeflectivities consistently showed hyperreflective borders and backscattering on OCT.
  • ICGA revealed hypofluorescence, and OCT-A showed non-detectable flow in these choroidal areas.

Conclusions:

  • Choroidal round hyporeflectivities beneath GA likely represent non-perfused or hypo-perfused choroidal vessels.
  • These findings suggest potential implications for understanding GA pathophysiology.
  • The observed hyporeflectivities may be associated with larger GA lesion areas.