Parapapillary choroidal microvasculature dropout in nonglaucomatous healthy eyes

To determine the incidence of parapapillary choroidal microvasculature dropout (MvD) in nonglaucomatous healthy eyes using optical coherence tomography angiography (OCTA) and to characterize the MvD observed in these eyes.

Seventy-six eyes (19 eyes with an MvD and 57 age-matched eyes without an MvD) from a cohort of 297 nonglaucomatous healthy eyes that underwent OCTA were included. The peripapillary choroidal microvasculature was evaluated in en-face images obtained using swept-source OCTA. An MvD was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the en-face images of the choroidal layer. The incidence of MvD and clinical characteristics associated with the presence of an MvD was determined.

MvD was found in 19 of the 297 nonglaucomatous healthy eyes (6.4%). Compared with age-matched eyes without an MvD, eyes with an MvD had lower systolic blood pressure (p = 0.021), diastolic blood pressure (p = 0.048), mean arterial pressure (p = 0.025) and mean ocular perfusion pressure (p = 0.032). Logistic regression analyses showed that cold extremities (p = 0.046), lower mean arterial pressure (p = 0.021) and lower mean ocular perfusion pressure (p = 0.023) were associated with the presence of an MvD.

Parapapillary choroidal MvD can be present in nonglaucomatous healthy eyes. The presence of an MvD is associated with systemic vascular dysregulation.