Flow Dynamic Patterns of Retinal-choroidal Anastomoses

Abstract

Abstract: : Purpose: Flow direction analysis of retinal-choroidal anastomoses in eyes with occult choroidal neovascularization in AMD. Methods: Prospective study of 28 consecutive eyes (26 patients) presenting RCA associated with occult choroidal new vessels (CNV) and/or pigment epithelial detachment (PED). High-speed ICG angiography allows the analysis of the early phase and the sequence of flow between RCA and CNV. The following angiographic characteristics were recorded: presence and size of PED, retinal or choroidal alterations and associated vascular abnormalities. Results: twenty one percent of the eyes presented several anastomoses the total number of which was 37. A PED was associated in 71%. Of the 37 anastomoses, 13% were arterial, 8% were venous and 78% had an arterial and venous retinal component. In 62% of cases, the vascular complex showed a filling pattern from a retinal artery to the CNV and then to a retinal vein. The blood flew directly from the CNV to a retinal vessel in 11% of cases, and from a retinal artery to CNV in 11% of cases. A direct anastomosis between a retinal artery and a retinal vein was connected with CNV in 17% of cases. Conclusions: This analysis aims to provide additive informations on the localisation in depth of the different components and on the sequence of blood flow. The diversity of filling patterns suggests that anastomoses could be a response to different alterations of the retina or of the choroids, initial or secondary, of which AMD might be only one of the components.

Keywords: age-related macular degeneration • imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • neovascularization