Optical coherence tomography angiography for visualization of retinal capillary plexuses in pachychoroid neovasculopathy

Objective: To evaluate retinal capillary plexus alterations in patients with pachychoroid neovasculopathy (PNV) by optical coherence tomographic angiography (OCTA). Design: Retrospective observational study. Participants: The study included 43 patients with PNV (43 eyes, PNV group) and 43 normal eyes (control group). Methods: All PNV participants underwent comprehensive ophthalmic examinations, including OCTA. The results were compared with those of the controls. Differences in superficial and deep vascular density between the groups were analyzed. The correlations between vascular density and subfoveal choroidal thickness (SFCT), age, best-corrected visual acuity, refraction, and axial length were analyzed. Results: The superficial vascular density of the macular region (except for the area of the fovea and the inferior parafoveal region) was significantly lower in the PNV group than the control group (p < 0.05). The deep vascular density of the macular region was significantly lower in the PNV group (p < 0.05). In the PNV group, there was no significant correlation between vascular density and SFCT, age, BVCA, refraction, or axial length (p > 0.05). Conclusions: Superficial and deep vascular densities of the macular region were lower in the patients with PNV compared with the patients in the control group. In the patients with PNV, the macular region showed signs of inner retinal capillary dropout, which may be caused by choroidal ischemia and/or a chronic impairment of nutrient supply to the retinal pigment epithelium.

Automated summary

Retinal capillary plexus alterations were evaluated in patients with PNV using OCTA, revealing lower vascular densities in the macular region of PNV patients compared to controls. This could be due to chronic impairment of nutrient supply or choroidal ischemia in PNV.