Choroidal thickness, vascular hyperpermeability, and complement factor H in age-related macular degeneration and polypoidal choroidal vasculopathy.

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Investigative ophthalmology & visual science (Impact Factor: 3.43). 05/2012; 53(7):3663-72. DOI: 10.1167/iovs.12-9619
Source: PubMed

ABSTRACT To investigate the relationship between subfoveal choroidal thickness, choroidal vascular hyperpermeability, and complement factor H (CFH) gene polymorphism in typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).
Fifty-eight patients with typical AMD and 63 patients with PCV underwent fluorescein angiography, indocyanine green angiography (IA), and spectral-domain optical coherence tomography (OCT) using enhanced depth imaging (EDI). Subfoveal choroidal thickness was measured using EDI-OCT images, and choroidal hyperpermeability was evaluated using late-phase IA images. The major AMD-associated single-nucleotide polymorphisms were genotyped in 86 patients.
Mean subfoveal choroidal thickness was significantly lower in eyes with typical AMD than that in eyes with PCV (P = 0.025). Subfoveal choroidal thickness was greater in eyes with choroidal hyperpermeability than that in eyes without it in typical AMD (P < 0.001) and PCV (P = 0.020), and in the fellow eyes of typical AMD (P < 0.001) and PCV (P = 0.027). In eyes without choroidal hyperpermeability, the mean subfoveal choroidal thickness was greater in PCV than that in typical AMD (P = 0.001). Choroidal thickness decreased after photodynamic therapy combined with intravitreal ranibizumab in typical AMD (P = 0.016) and PCV (P = 0.036). In eyes with PCV, the I62V polymorphism in the CFH gene contributed to choroidal thickness (P = 0.043).
Choroidal thickness is related to the AMD subtypes, choroidal hyperpermeability, and I62V CFH gene polymorphism. In eyes without choroidal hyperpermeability, EDI-OCT is useful as an auxiliary measure for differentiating typical AMD and PCV.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare and analyze differences and similarities between Japanese and French patients in subtype diagnosis of exudative age-related macular degeneration (AMD) as determined by fundus photography (FP) and fluorescein angiography (FA), and a multimodal imaging involving FP, FA, indocyanine green angiography (ICGA), and optical coherence tomography (OCT).
    American Journal of Ophthalmology 05/2014; · 4.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose To characterize punctate hyperfluorescence spot as common choroidopathy in central serous chorioretinopathy (CSC) and polypoidal choroidal vasculopathy (PCV). Design Cross-sectional retrospective study. Methods A total of 150 patients with 50 each allocated to CSC, PCV, and typical neovascular age-related macular degeneration (AMD) groups were included. Punctate hyperfluorescence spot was determined using mid-to-late phase indocyanine green angiography and subfoveal choroidal thickness by enhanced-depth imaging optical coherence tomography. Each group was subcategorized based on concurrent punctate hyperfluorescence spot. Results The punctate hyperfluorescence spot incidence was higher in CSC (80.0%) and PCV (86.0%) than AMD (40.0%, P<0.001), with similar contralateral findings (86.1%, 86.7%, and 60%, respectively, p=0.014). Punctate hyperfluorescence spot lesions comprised clustered polyps connected to vascular networks mimicking PCV. Choroidal thickness was 370.7±81.9μm, 332.6±101.6μm, and 172.5±80.1μm in affected eyes (p<0.001) and 323.0±70.5μm, 306.4±94.4μm, and 180.2±83.6μm in contralateral eyes (p<0.001) in CSC, PCV, and AMD groups, respectively. In AMD group, choroidal thickness was greater in eyes with punctate hyperfluorescence spot (204.8±92.3μm) than in those without punctate hyperfluorescence spot (150.2±62.9μm, p=0.028) in affected eyes, however, the difference was not observed in contralateral eyes in AMD group and in both eyes in CSC and PCV groups. Conclusions Based on angiography and OCT, punctate hyperfluorescence spot may be a form of PCV, and CSC and PCV may share common choroidopathy distinct from typical neovascular AMD. However, infrequent PHS lesions along with thickened choroids in AMD eyes suggest that AMD may encompass a wide choroidal pathologic spectrum shared in part with PCV.
    American Journal of Ophthalmology 12/2014; · 4.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated subfoveal choroidal thickness measured with two different forms of optical coherence tomography (OCT), enhanced-depth imaging (EDI) and swept-source (SS) OCT, in central serous chorioretinopathy (CSC). Fifty-six eyes of 48 patients diagnosed with acute or chronic CSC, were studied prospectively. Subfoveal choroidal thickness was measured as the distance between the outer border of the retinal pigment epithelium-Bruch's membrane complex, and the chorioscleral border under the fovea. Subfoveal choroidal thickness was measured using EDI-OCT and SS-OCT. We also measured serous retinal detachment (SRD) only with SS-OCT. The Pearson correlation coefficient was used to assess the correlation between subfoveal choroidal thickness values determined by the two different OCT modalities. The mean patient age was 52 +/- 13 years (range, 32-82 years). Among the 56 eyes, 21 had acute CSC and 35 had chronic CSC. Subfoveal choroidal thickness measured with EDI-OCT was 336.6 +/- 91.6 mum in acute and 388.0 +/- 103.4 mum in chronic CSC. With SS-OCT, the thickness in acute CSC was 332.0 +/- 96.7 mum and that in chronic CSC was 392.6 +/- 101.3 mum. Acute CSC (p <0.001, correlation coefficient; r =0.99) and chronic CSC (p <0.001, correlation coefficient; r =0.97) values obtained with the two different OCT modalities correlated significantly. Among the 56 eyes, 43 (19 eyes with acute and 24 with chronic CSC) were evaluable for SRD height by SS-OCT. The mean SRD height was 128.9 +/- 83.6 mum in acute cases and 96.3 +/- 62.0 mum in chronic cases. Subfoveal choroidal thickness obtained with two different OCT modalities correlated significantly.
    BMC Ophthalmology 11/2014; 14(1):145. · 1.08 Impact Factor