Pilot Study of Choroidal Synphlebia.

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Choroidal synphlebia is a newly identified configuration of the choroidal venous system.
• Understanding its imaging features and clinical associations is crucial for diagnosing and managing related ocular conditions.

Purpose of the Study:

• To describe the multimodal imaging characteristics of choroidal synphlebia.
• To investigate the clinical associations of this novel venous configuration.

Main Methods:

• Retrospective analysis of patients imaged with a swept-source OCT system allowing deep choroidal penetration.
• Definition of choroidal synphlebia as a confluent vascular structure ≥750 µm.
• Evaluation of multimodal imaging features.

Main Results:

• Nineteen eyes of sixteen patients showed choroidal synphlebia.
• Associated diagnoses included central serous chorioretinopathy (16 eyes) and neovascular AMD (2 eyes).
• Two patterns observed: lobulated venous lakes or caput medusa-type arrangements, often near watershed zones.

Conclusions:

• Choroidal synphlebia is a distinct choroidal venous phenotype with fused major veins and absent overlying vessels.
• It may impact choroidal hemodynamics, potentially explaining treatment-resistant CSC and neovascular presentations.
• Recognition aids understanding of choroidal venous drainage and associated pathologies.