Imaging in Pachychoroid Disease

Area of Science:

• Ophthalmology
• Medical Imaging
• Pathology

Background:

• Pachychoroid describes increased choroidal thickness, often with large choroidal vessel dilation.
• This can compress choriocapillaris and Sattler's layer, leading to various pathological findings.
• Pachychoroid spectrum diseases share common choroidal morphological characteristics.

Purpose of the Study:

• To define the morphological characteristics of the pachychoroid spectrum of diseases.
• To review recent advancements in imaging modalities for understanding pachychoroid conditions.

Main Methods:

• Review of current literature and imaging techniques.
• Analysis of findings from widefield indocyanine green angiography (WF-ICGA) and optical coherence tomography angiography (OCTA).
• Examination of scleral thickness measurements using ultrasound biomicroscopy and anterior segment OCT.

Main Results:

• WF-ICGA identified peripheral retinal venous outflow congestion in pachychoroid diseases.
• Thicker anterior sclera may contribute to choroidal congestion and disease pathogenesis.
• OCTA demonstrates superior sensitivity and specificity for detecting choroidal neovascularization (CNV).

Conclusions:

• Advanced imaging significantly enhances the understanding of pachychoroid diseases.
• Morphological definition aids in diagnosis and potentially guides future therapeutic strategies.
• Pachychoroid spectrum diseases present with distinct choroidal and scleral alterations.