Structural changes in vortex vein ampullae in eyes with pachychoroid-spectrum disorder

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Pachychoroid-spectrum disorders represent a group of conditions characterized by choroidal thickening and other related pathologies.
• Vortex vein ampullae are crucial venous drainage channels in the choroid, and their morphology may be affected in various ocular diseases.

Purpose of the Study:

• To investigate and characterize the morphological features of vortex vein ampullae in patients with pachychoroid-spectrum disorders.
• To compare the vortex vein ampullae characteristics between individuals with pachychoroid-spectrum disorders and healthy controls.

Main Methods:

• A case-control study was conducted using the Optos Silverstone imaging device, which combines ultra-widefield scanning laser fundus imaging with swept-source optical coherence tomography.
• Morphological parameters of supratemporal and infratemporal vortex vein ampullae were evaluated and compared between 40 patients (46 eyes) with pachychoroid-spectrum disorders and 14 healthy controls (15 eyes).
• Statistical analyses were performed to compare parameters, including luminal volume and vessel diameter, with adjustments for potential confounders.

Main Results:

• No significant differences were found in the morphological parameters of supratemporal vortex vein ampullae between the groups.
• Eyes with pachychoroid-spectrum disorders exhibited significantly larger mean infratemporal vortex vein ampullae luminal volume and greater mean vessel diameter compared to controls (P < 0.001 and P = 0.040, respectively).
• These infratemporal alterations persisted after adjusting for confounders (P ≤ 0.011), with observed enlargement exclusively in the infratemporal vortex vein ampullae.

Conclusions:

• Pachychoroid-spectrum disorders are associated with specific morphological changes, namely enlargement of the lumen and stroma, in the infratemporal vortex vein ampullae.
• The observed alterations in infratemporal vortex vein ampullae suggest a complex pathophysiology in pachychoroid-spectrum disorders.
• Impaired choroidal drainage alone may not fully explain the observed vortex vein ampullae changes in these conditions.