Abstract
Purpose :
Superior and inferior macular vortex veins are responsible for choroidal drainage in the posterior pole. Both vortex veins are divided by horizontal watershed through the macula. Compared with normal control, we evaluated the remodeling of macular vortex veins in pachychoroid neovasculopathy (PNV).
Methods :
30 eyes of 30 patients (male 26, female 4, mean age, 64yr) with PNV and 30 normal control (male 20, female 10, mean age, 63yr) were enrolled. PNV was diagnosed by the presence of choroidal neovascularization (CNV) detected by fluorescein and indocyanine green angiography, a shallow irregular retinal pigment epithelium (RPE) detachment with dilated outer choroidal vessels in B-mode optical coherence tomography (OCT), and sub-RPE CNV detected by OCT angiography. We assessed the feature of macular vortex veins by en face OCT and central choroidal thickness (CCT) by B-mode OCT.
Results :
In normal 30 eyes, superior and inferior vortex veins are symmetrically distributed in 19 eyes (63.3%), while they were asymmetric in 11 eyes (36.7%). Horizontal watershed was identified in 24 eyes (80%). Venous anastomosis between superior and inferior vortex veins was observed in 6 eyes (20%). Mean CCT was 233 μm. In 30 eyes with PNV, superior and inferior vortex veins were symmetric in 15 eyes (50%) and asymmetric 15 eyes (50%). In 27 of 30 eyes (90%), horizontal watershed disappeared, instead, anastomosis developed between superior and inferior vortex veins. Mean CCT was 357 μm. Dilated vortex veins in en face OCT were always seen underlying the sub-RPE CNV detected by OCT angiography.
Conclusions :
Remodeling of choroidal drainage route by venous anastomosis between superior and inferior vortex veins commonly developed in PNV eyes. It suggests longstanding congestion of contralateral vortex vein.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.