INTERVORTEX VENOUS ANASTOMOSIS IN Pachychoroid-RELATED DISORDERS

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Pachychoroid-related diseases encompass a spectrum of conditions affecting the choroid.
• Understanding the vascular anatomy, particularly the vortex vein systems, is crucial for elucidating disease mechanisms.

Purpose of the Study:

• To investigate the choroidal vascular patterns in patients with pachychoroid-related diseases using wide-field indocyanine green angiography.
• To evaluate the presence and significance of anastomoses between vortex vein systems in these conditions.

Main Methods:

• Retrospective analysis of wide-field indocyanine green angiographic images.
• Inclusion of patients diagnosed with pachychoroid, peripapillary pachychoroid syndrome, central serous chorioretinopathy, and pachychoroid-associated neovascularization.
• Assessment for anastomoses between the superonasal, superotemporal, inferotemporal, and inferonasal vortex vein systems.

Main Results:

• All evaluated eyes (n=42) exhibited anastomosis between the superonasal, superotemporal, and inferotemporal vortex vein systems.
• The inferonasal vortex vein system showed anastomosis in most cases, particularly in peripapillary pachychoroid syndrome.
• Anastomotic connections were more prevalent in the pachychoroid disease group compared to controls, especially in the inferonasal quadrant.

Conclusions:

• Intervortex venous anastomosis is a common finding in pachychoroid, central serous chorioretinopathy, peripapillary pachychoroid syndrome, and pachychoroid-associated neovascularization.
• These anastomoses may play a significant role in the pathogenesis of these diseases.
• The findings necessitate a re-evaluation of current disease classification and understanding.