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Delia DeBuc, Jing Tian, Thalmon R Campagnoli, Wen-Hsiang Lee, Hong Jiang, Jianhua Wang, Sagi ------- Reuven, Amiram Grinvald, William E Smiddy, Gabor Mark Somfai; Atypical vascularization of the foveal avascular zone in the human macula. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3407. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To present different patterns of atypical foveal vascularization observed in healthy individuals and in patients with a variety of ocular and systemic diseases during studies with the retinal functional imager (RFI, Optical Imaging Ltd., Rehovot, Israel).
We analyzed the study data of subjects enrolled in studies involving healthy controls and patients with diabetes and no retinopathy, diabetes and mild non-proliferative diabetic retinopathy, central and branch retinal vein occlusion and multiple sclerosis (MS). All subjects underwent retinal blood flow imaging and capillary perfusion mapping using the RFI. We were aiming to identify abnormally crossing capillaries in the region of the foveal avascular zone (FAZ).
Abnormal FAZ pattern was present in 8 (4%) of 224 eyes of 6 (6%) of 107 patients (36 ±8 years old). Those with atypical FAZ patterns were a type 2 diabetic female without diabetic retinopathy, three seemingly healthy males, one female with MS and one male with cystoid macular edema due to central retinal vein occlusion. Retinal circulation and capillary patterns showed abnormal FAZ in both healthy and pathological patients (see Fig. 1). Specifically, all retinas contained capillaries crossing the fovea in various patterns. The blood flow pattern of the atypical perifoveal capillaries was indistinguishable from that of the more peripheral capillaries. In adition, the size of the FAZ was variable and smaller in area than in the normal healthy population as reported in the literature.
Recent advances in in vivo optical imaging technologies have enabled better visualization of the perifoveal capillary bed, showing vasculature that is not apparent by other means (e.g. fundus photo). The findings of this study have demonstrated patterns of retinal circulation in the FAZ where capillaries are usually absent. These patterns are present in apparently healthy patients as well as in patients with various ocular and systemic diseases. Further studies should investigate whether atypical perifoveal capillary patterns in the FAZ are induced by disease, degeneration or have a developmental explanation. Such studies will better inform our understanding of the factors that may determine atypical capillary occurrence, significance and their relationship to macular function.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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