nach oben

Graefe's Archive for Clinical and Experimental Ophthalmology

Erschienen in:

16.02.2023 | Retinal Disorders

Changes in choriocapillaris structure occurring in idiopathic macular hole before and after vitrectomy

verfasst von: Hiroaki Endo, Satoru Kase, Mitsuo Takahashi, Yuki Ito, Shozo Sonoda, Tomonori Sakoguchi, Taiji Sakamoto, Satoshi Katsuta, Susumu Ishida, Manabu Kase

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 7/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to analyze the anatomical choroidal vascular layers and the changes in idiopathic macular hole (IMH) eyes over time after vitrectomy.

Methods

This is a retrospective observational case–control study. Fifteen eyes from 15 patients who received vitrectomy for IMH and age-matched 15 eyes from 15 healthy controls were enrolled in this study. Retinal and choroidal structures were quantitatively analyzed before vitrectomy and 1 and 2 months after surgery using spectral domain-optical coherence tomography. Each choroidal vascular layer was divided into the choriocapillaris, Sattler’s layer, and Haller’s layer, and then, the choroidal area (CA), luminal area (LA), stromal area (SA), and central choroidal thickness (CCT) were calculated using binarization techniques. The ratio of LA to CA was defined as the L/C ratio.

Results

The CA, LA, and L/C ratios were 36.9 ± 6.2, 23.4 ± 5.0, and 63.1 ± 7.2 in the choriocapillaris of IMH and were 47.3 ± 6.6, 38.3 ± 5.6, and 80.9 ± 4.1 in that of control eyes, respectively. Those values were significantly lower in IMH eyes than in control eyes (each P < 0.01), whereas there was no significant difference in total choroid, Sattler’s layer, and Haller’s layer or CCT. The ellipsoid zone defect length showed a significant negative correlation with the L/C ratio in total choroid and with CA and LA in the choriocapillaris of IMH (R = − 0.61, P < 0.05, R = − 0.77, P < 0.01, and R = − 0.71, P < 0.01, respectively). In the choriocapillaris, the LA were 23.4 ± 5.0, 27.7 ± 3.8, and 30.9 ± 4.4, and the L/C ratios were 63.1 ± 7.2, 74.3 ± 6.4, and 76.6 ± 5.4 at baseline, 1 month, and 2 months after vitrectomy, respectively. Those values showed a significant increase over time after surgery (each P < 0.05), whereas the other choroidal layers did not alter consistently with respect to changes in choroidal structure.

Conclusions

The current OCT-based study demonstrated that the choriocapillaris was exclusively disrupted between choroidal vascular structures in IMH, which may correlate with the ellipsoid zone defect. Furthermore, the L/C ratio of choriocapillaris recovered after IMH repair, suggesting an improved balance between supply and demand of oxygen that has collapsed due to temporary loss of central retinal function by IMH.

Gass JDM (1988) Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol 106:629–639. https://doi.org/10.1001/ARCHOPHT.1988.01060130683026CrossRefPubMed

Johnson RN, Gass JDM (1988) Idiopathic macular holes. Observations, stages of formation, and implications for surgical intervention. Ophthalmology 95:917–924. https://doi.org/10.1016/S0161-6420(88)33075-7CrossRefPubMed

Aras C, Ocakoglu O, Akova N (2004) Foveolar choroidal blood flow in idiopathic macular hole. Int Ophthalmol 25:225–232. https://doi.org/10.1007/S10792-005-5014-4CrossRefPubMed

Zhang P, Zhou M, Wu Y et al (2017) CHOROIDAL thickness in unilateral idiopathic macular hole: a cross-sectional study and meta-analysis. Retina 37:60–69. https://doi.org/10.1097/IAE.0000000000001118CrossRefPubMed

Pichi F, Aggarwal K, Neri P et al (2018) Choroidal biomarkers. Indian J Ophthalmol 66:1716–1726. https://doi.org/10.4103/IJO.IJO_893_18CrossRefPubMedPubMedCentral

Sonoda S, Sakamoto T, Yamashita T et al (2015) Luminal and stromal areas of choroid determined by binarization method of optical coherence tomographic images. Am J Ophthalmol 159:1123-1131.e1. https://doi.org/10.1016/J.AJO.2015.03.005CrossRefPubMed

Agrawal R, Gupta P, Tan KA, et al (2016) Choroidal vascularity index as a measure of vascular status of the choroid: Measurements in healthy eyes from a population-based study. Sci Rep 6 https://doi.org/10.1038/SREP21090

Sonoda S, Sakamoto T, Kuroiwa N, et al (2016) Structural changes of inner and outer choroid in central serous chorioretinopathy determined by optical coherence tomography. PLoS One 11 https://doi.org/10.1371/JOURNAL.PONE.0157190

Ting DSW, Yanagi Y, Agrawal R, et al (2017) Choroidal remodeling in age-related macular degeneration and polypoidal choroidal vasculopathy: a 12-month prospective study. Sci Rep 7 https://doi.org/10.1038/S41598-017-08276-4

10.

Ng WY, Ting DSW, Agrawal R et al (2016) Choroidal structural changes in myopic choroidal neovascularization after treatment with antivascular endothelial growth factor over 1 year. Invest Ophthalmol Vis Sci 57:4933–4939. https://doi.org/10.1167/IOVS.16-20191CrossRefPubMed

11.

Kase S, Endo H, Takahashi M et al (2020) Alteration of choroidal vascular structure in diabetic retinopathy. Br J Ophthalmol 104:417–421. https://doi.org/10.1136/BJOPHTHALMOL-2019-314273CrossRefPubMed

12.

Kase S, Endo H, Takahashi M et al (2022) Involvements of choroidal vascular structures with local treatments in patients with diabetic macular edema. Eur J Ophthalmol 32:450–459. https://doi.org/10.1177/11206721211027103CrossRefPubMed

13.

Kase S, Endo H, Takahashi M et al (2021) Choroidal vascular structures in diabetic patients: a meta-analysis. Graefes Arch Clin Exp Ophthalmol 259:3537–3548. https://doi.org/10.1007/S00417-021-05292-ZCrossRefPubMed

14.

Mitamura Y, Enkhmaa T, Sano H et al (2021) Changes in choroidal structure following intravitreal aflibercept therapy for retinal vein occlusion. Br J Ophthalmol 105:704–710. https://doi.org/10.1136/BJOPHTHALMOL-2020-316214CrossRefPubMed

15.

Kawano H, Sonoda S, Yamashita T et al (2016) Relative changes in luminal and stromal areas of choroid determined by binarization of EDI-OCT images in eyes with Vogt-Koyanagi-Harada disease after treatment. Graefes Arch Clin Exp Ophthalmol 254:421–426. https://doi.org/10.1007/S00417-016-3283-4CrossRefPubMed

16.

Egawa M, Mitamura Y, Niki M et al (2019) Correlations between choroidal structures and visual functions in eyes with retinitis pigmentosa. Retina 39:2399–2409. https://doi.org/10.1097/IAE.0000000000002285CrossRefPubMed

17.

Chun H, Kim JY, Kwak JH, et al (2021) The effect of phacoemulsification performed with vitrectomy on choroidal vascularity index in eyes with vitreomacular diseases. Sci Rep 11 https://doi.org/10.1038/S41598-021-99440-4

18.

Sonoda S, Sakamoto T, Kakiuchi N et al (2018) Semi-automated software to measure luminal and stromal areas of choroid in optical coherence tomographic images. Jpn J Ophthalmol 62:179–185. https://doi.org/10.1007/S10384-017-0558-1CrossRefPubMed

19.

Sonoda S, Terasaki H, Kakiuchi N et al (2019) Kago-Eye2 software for semi-automated segmentation of subfoveal choroid of optical coherence tomographic images. Jpn J Ophthalmol 63:82–89. https://doi.org/10.1007/S10384-018-0631-4CrossRefPubMed

20.

Kinoshita T, Mitamura Y, Mori T, et al (2016) Changes in choroidal structures in eyes with chronic central serous chorioretinopathy after half-dose photodynamic therapy. PLoS One 11 https://doi.org/10.1371/JOURNAL.PONE.0163104

21.

Endo H, Kase S, Takahashi M et al (2018) Alteration of layer thickness in the choroid of diabetic patients. Clin Exp Ophthalmol 46:926–933. https://doi.org/10.1111/CEO.13299CrossRefPubMed

22.

Ullrich S, Haritoglou C, Gass C et al (2002) Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol 86:390–393. https://doi.org/10.1136/BJO.86.4.390CrossRefPubMedPubMedCentral

23.

Kusuhara S, Teraoka Escaño MF, Fujii S et al (2004) Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol 138:709–716. https://doi.org/10.1016/J.AJO.2004.04.063CrossRefPubMed

24.

Ruiz-Moreno JM, Staicu C, Piñero DP et al (2008) Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol 92:640–644. https://doi.org/10.1136/BJO.2007.136176CrossRefPubMed

25.

Laviers H, Zambarakji H (2014) Enhanced depth imaging-OCT of the choroid: a review of the current literature. Graefes Arch Clin Exp Ophthalmol 252:1871–1883. https://doi.org/10.1007/S00417-014-2840-YCrossRefPubMed

26.

Teng Y, Yu M, Wang Y et al (2017) OCT angiography quantifying choriocapillary circulation in idiopathic macular hole before and after surgery. Graefes Arch Clin Exp Ophthalmol 255:893–902. https://doi.org/10.1007/S00417-017-3586-0CrossRefPubMed

27.

Gedik B, Suren E, Bulut M, et al (2021) Changes in choroidal blood flow in patients with macular hole after surgery. Photodiagnosis Photodyn Ther 35 https://doi.org/10.1016/J.PDPDT.2021.102428

28.

Tornambe PE (2003) Macular hole genesis: the hydration theory. Retina 23:421–424. https://doi.org/10.1097/00006982-200306000-00028CrossRefPubMed

29.

Nair U, Sheth JU, Indurkar A, Soman M (2021) Intraretinal cysts in macular hole: a structure-function correlation based on en face imaging. Clin Ophthalmol 15:2953–2962. https://doi.org/10.2147/OPTH.S321594CrossRefPubMedPubMedCentral

30.

Sano M, Shimoda Y, Hashimoto H, Kishi S (2009) Restored photoreceptor outer segment and visual recovery after macular hole closure. Am J Ophthalmol 147 https://doi.org/10.1016/J.AJO.2008.08.002

31.

Michalewska Z, Michalewski J, Adelman RA, Nawrocki J (2010) Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology 117:2018–2025. https://doi.org/10.1016/J.OPHTHA.2010.02.011CrossRefPubMed

32.

Wang X, Zhang T, Jiang R, Xu G (2021) Vitrectomy for laser-induced full-thickness macular hole. BMC Ophthalmol 21 https://doi.org/10.1186/S12886-021-01893-8

33.

Okamoto M, Matsuura T, Ogata N (2014) Ocular blood flow before, during, and after vitrectomy determined by laser speckle flowgraphy. Ophthalmic Surg Lasers Imaging Retina 45:118–124. https://doi.org/10.3928/23258160-20140306-04CrossRefPubMed

34.

Hashimoto Y, Saito W, Saito M et al (2015) Decreased choroidal blood flow velocity in the pathogenesis of multiple evanescent white dot syndrome. Graefes Arch Clin Exp Ophthalmol 253:1457–1464. https://doi.org/10.1007/S00417-014-2831-ZCrossRefPubMed

35.

Hanyuda N, Akiyama H, Shimoda Y et al (2017) Different filling patterns of the choriocapillaris in fluorescein and indocyanine green angiography in primate eyes under elevated intraocular pressure. Invest Ophthalmol Vis Sci 58:5856–5861. https://doi.org/10.1167/IOVS.17-22223CrossRefPubMed

36.

Endo H, Kase S, Takahashi M, et al (2020) Relationship between diabetic macular edema and choroidal layer thickness. PLoS One 15 https://doi.org/10.1371/JOURNAL.PONE.0226630

Titel: Changes in choriocapillaris structure occurring in idiopathic macular hole before and after vitrectomy
verfasst von: Hiroaki Endo
Satoru Kase
Mitsuo Takahashi
Yuki Ito
Shozo Sonoda
Tomonori Sakoguchi
Taiji Sakamoto
Satoshi Katsuta
Susumu Ishida
Manabu Kase
Publikationsdatum: 16.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 7/2023
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06004-5

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Metastasen Leitthema

Orbitale und periokuläre metastatische Tumoren galten früher als sehr selten. Aber mit der ständigen Aktualisierung von Medikamenten und Nachweismethoden für die Krebsbehandlung werden neue Chemotherapien und Strahlenbehandlungen eingesetzt. Die …

Staging und Systemtherapie bei okulären und periokulären Metastasen

Metastasen Leitthema

Metastasen bösartiger Erkrankungen sind die häufigsten Tumoren, die im Auge diagnostiziert werden. Sie treten bei ungefähr 5–10 % der Patienten mit soliden Tumoren im Verlauf der Erkrankung auf. Besonders häufig sind diese beim Mammakarzinom und …

CME: Wundheilung nach Trabekulektomie

Trabekulektomie CME-Artikel

Wird ein Glaukom chirurgisch behandelt, ist die anschließende Wundheilung von entscheidender Bedeutung. In diesem CME-Kurs lernen Sie, welche Pathomechanismen der Vernarbung zugrunde liegen, wie perioperativ therapiert und Operationsversagen frühzeitig erkannt werden kann.

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Metastasen Leitthema

Peri- sowie intraokuläre Metastasen sind insgesamt gesehen selten und meist Zeichen einer fortgeschrittenen primären Tumorerkrankung. Die Therapie ist daher zumeist palliativ und selten kurativ. Zudem ist die Therapiefindung sehr individuell. Die …

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Changes in choriocapillaris structure occurring in idiopathic macular hole before and after vitrectomy

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Staging und Systemtherapie bei okulären und periokulären Metastasen

CME: Wundheilung nach Trabekulektomie

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Update Augenheilkunde

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2023

Correlation between the ablation ratio and posterior corneal stability after small incision lenticule extraction for high myopia

Hormone Replacement Therapy and the Incidence of Nonarteritic Anterior Ischemic Optic Neuropathy: a Nationwide Population-Based Study (2009–2018)

Circumferential (360°) trabeculotomy for steroid-induced glaucoma in adults

Impact of intravitreal injection therapy on contrast sensitivity in patients with nAMD and DME

Letter to the editor regarding “A novel tandem duplication of PRDM13 in a Chinese family with North Carolina macular dystrophy”

Clinical phenotypes of euthyroid, hyperthyroid, and hypothyroid thyroid-associated ophthalmopathy

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Staging und Systemtherapie bei okulären und periokulären Metastasen

CME: Wundheilung nach Trabekulektomie

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Update Augenheilkunde