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Hyperreflective Choroidal Vessels in Geographic Atrophy Secondary to Age-Related Macular Degeneration
Insights
Hyperreflective choroidal vessels (HRCVs) are visible on multicolor imaging in geographic atrophy (GA). HRCVs indicate larger GA areas and thinner choroids, suggesting they may mark advanced age-related macular degeneration.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Macular Degeneration Research
Background:
- Geographic atrophy (GA) is a form of age-related macular degeneration (AMD).
- Choroidal vessels can appear as hyperreflective choroidal vessels (HRCVs) on multicolor (MC) imaging in GA.
- Understanding HRCVs aids in assessing AMD progression.
Purpose of the Study:
- To describe and characterize choroidal vessels in GA areas that appear as HRCVs on MC imaging.
- To correlate HRCV presence with GA size and choroidal thickness (CT).
Main Methods:
- Retrospective case series of patients diagnosed with GA.
- Multimodal imaging, including MC imaging, fundus autofluorescence, and indocyanine green angiography, was utilized.
- Quantitative analysis of GA area and CT was performed.
Main Results:
- HRCVs were clearly distinguishable on MC imaging and hyperautofluorescent on fundus autofluorescence.
- HRCVs correlated with late-phase hypocyanescence on indocyanine green angiography.
- Eyes with HRCVs had significantly larger GA areas (4.19 mm vs. 3.22 mm) and thinner CT (78.5 µm vs. 155.4 µm) compared to eyes without HRCVs.
Conclusions:
- HRCVs are readily identifiable on MC imaging in GA.
- The presence of HRCVs is associated with larger GA areas and reduced CT.
- HRCVs may serve as a potential biomarker for more advanced stages of GA.
Background And Objective:
To describe choroidal vessels in areas of geographic atrophy (GA) secondary to age-related macular degeneration that appear as hyperreflective choroidal vessels (HRCVs) on multicolor (MC) imaging.
Patients And Methods:
Retrospective case series of patients with GA. Multimodal imaging evaluation was performed.
Results:
HRCVs, which seem to be sclerotic on MC imaging, appeared as hyperautofluorescent on fundus autofluorescence, clearly distinguishable over the background of hypo-autofluorescence, and correlated with late-phase hypocyanescence areas on indocyanine green angiography. Average size of GA areas was significantly larger in eyes with (4.19 mm ± 0.83 mm) compared to eyes without (3.22 mm ± 1.05 mm) HRVCs (P = .0002). Similarly, mean choroidal thickness (CT) was significantly thinner in eyes with (78.5 µm ± 33.8 µm) compared to eyes without (155.4 µm ± 69.8 µm) HRVCs (P < .0001).
Conclusions:
HRCVs are more clearly distinguishable than other choroidal vessels on MC imaging in GA. HRCV identification is more frequent in eyes with larger areas of atrophy and reduced CT, and thus possibly represent a maker of more advanced GA. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1106-1114.].
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