CHOROIDAL CAVERNS AND CHOROIDAL ROUND HYPOREFLECTIVITIES IN GEOGRAPHIC ATROPHY

Abstract

Purpose : To describe and investigate “choroidal caverns” and “choroidal round hyporeflectivities “, two optical coherence tomography (OCT) findings in the choroid of patients affected by geography atrophy (GA) secondary to non-neovascular age related macular degeneration (AMD).

Methods : In this retrospective analysis of patients with GA the main outcome measures included evaluation of choroidal caverns and choroidal round hyporeflectivities, their localization and relation with retinal/choroidal structures. Patients underwent a complete ophthalmologic examination including Indocyanine green angiography (ICGA), structural OCT and Optical Coherence Tomography Angiography (OCT-A). The correspondence between the two findings beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed.

Results : Two hundred and one eyes of 120 consecutive patients (mean age 80.5±8.61 years) with GA were included. Fourty-three caverns have been found by OCT in Haller and Sattler layers in 17 eyes of 15 patients, whilst 29 round hyporeflectivities have been found by OCT in both choroidal layers in 21 eyes of other 15 patients. There are several differences between the two findings which include shape, borders and anatomical locations. Choroidal caverns appear on OCT as gaping hyporeflective cavities in the choroid, typically angular without hyperreflective borders often with punctate/linear hyperreflectivities internally; whereas choroidal round hyporeflectivities are round / oval hyporeflectivities, typically delimited by hyperreflective borders characterized by backscattering.

Conclusions : Our results suggest that choroidal round hyporeflectivities beneath GA may represent precursors of choroidal caverns and both may possible arise from non-perfused ghost vessels.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.