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Updated: Oct 30, 2025
Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
Published on: February 18, 2022
Decrease of choriocapillary vascular density measured by optical coherence tomography angiography in
Anyi Liang1, Shanshan Jia2, Fei Gao1
1Department of Ophthalmology, Peking Union Medical College Hospital (Dongdan Campus), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
Insights
Choriocapillary vascular density (CC VD) is reduced in all stages of Vogt-Koyanagi-Harada (VKH) disease. Optical coherence tomography angiography (OCTA) can monitor VKH activity and predict visual prognosis.
Area of Science:
- Ophthalmology
- Vascular Biology
- Medical Imaging
Background:
- Vogt-Koyanagi-Harada (VKH) disease is a systemic inflammatory condition affecting ocular tissues.
- Changes in choroidal circulation during VKH disease progression are not fully understood.
- Optical coherence tomography angiography (OCTA) allows for non-invasive assessment of choriocapillary vascular density (CC VD).
Purpose of the Study:
- To compare CC VD in different stages of VKH disease.
- To analyze the correlation between CC VD and clinical parameters.
- To explore the clinical significance of CC VD in VKH disease management.
Main Methods:
- Retrospective case series including 114 VKH patients and 47 normal controls.
- OCTA imaging to measure CC VD in acute, convalescent, and chronic recurrent stages of VKH.
- Comparison of CC VD with best-corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT).
Main Results:
- CC VD was significantly lower in all VKH disease stages compared to normal controls.
- CC VD increased with inflammation resolution and decreased during anterior uveitis relapse.
- Lower CC VD in the convalescent stage was associated with a history of anterior recurrence.
- CC VD showed a negative correlation with BCVA.
Conclusions:
- CC VD is decreased across all stages of VKH disease.
- CC VD may serve as a biomarker for monitoring uveitis activity in VKH.
- OCTA is a valuable tool for evaluating choroidal vascularity and CC VD in VKH patients.
- Further research is needed to establish OCTA's role in VKH progression monitoring and clinical decision-making.
Purpose:
Changes of choroidal circulation throughout the disease course of Vogt-Koyanagi-Harada (VKH) disease and the clinical significance remain unclear. Choriocapillary vascular density (CC VD) measured by optical coherence tomography angiography (OCTA) were compared in different disease stages of VKH and its correlation with other parameters was analyzed, aiming to explore their clinical relevance.
Methods:
This is a retrospective case series. One hundred and fourteen VKH patients and 47 normal controls (NCs) were included. Patients were grouped into the acute uveitic, convalescent, and chronic recurrent stages (only anterior recurrent cases included), and OCTA images were obtained from VKH patients in these stages. Best corrected visual acuity (BCVA), CC VD, and subfoveal choroidal thickness (SFCT) were recorded and compared.
Results:
CC VD in acute (58.26% ± 0.84%), convalescent (64.85% ± 0.33%), and chronic recurrent (62.78% ± 0.70%) stage of VKH patients were all significantly lower than that in NCs (66.37% ± 0.41%) (p < 0.001, p = 0.017, and p < 0.001, respectively). CC VD increased by 6.59% ± 0.91% with resolution of acute inflammation (p < 0.001) and decreased by 2.07% ± 0.74% during anterior uveitis relapse (p = 0.009). Patients with a positive history of anterior recurrence had lower CC VD (- 2.43% ± 0.75%, p = 0.003) in the convalescent stage than those without. CC VD was negatively correlated with logMAR BCVA in VKH (r = - 0.261, p < 0.001).
Conclusion:
CC VD was decreased in every stage of VKH. CC VD has the potential to reflect the status of uveitis and might be promising in monitoring the disease activity. OCTA is a convenient and straightforward tool to evaluate choroidal vascularity, and CC VD provides supplemental quantitative information of the choriocapillaris. Further studies are needed to explore the values of OCTA quantitative parameters in monitoring VKH progression, predicting visual prognosis, and guiding clinical decisions.
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