July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Assessing Foveal Morphology in Individuals with Fragmented Foveal Avascular Zones
Author Affiliations & Notes
  • Rachel E Linderman
    Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Jenna Cava
    Ophthalmology & Visual Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Alison L Huckenpahler
    Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Brittany Rego
    Ophthalmology & Visual Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Toco Yuen Ping Chui
    Ophthalmology, New York Ear and Eye Infirmary of Mount Sinai, New York, New York, United States
  • Richard B Rosen
    Ophthalmology, New York Ear and Eye Infirmary of Mount Sinai, New York, New York, United States
  • Joseph Carroll
    Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
    Ophthalmology & Visual Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Rachel Linderman, OptoVue (C); Jenna Cava, None; Alison Huckenpahler, None; Brittany Rego, None; Toco Chui, None; Richard Rosen, Advanced Cellular Technologies (C), Carl Zeiss Meditech (C), Clarity (C), NanoRetina (C), OD-OS (C), Opticology (I), OptoVue (C), Regeneron (C); Joseph Carroll, MeiraGTX (C), OptoVue (F)
  • Footnotes
    Support  R01EY024969, P30EY001931, R01EY027301, F30EY027706
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4313. doi:https://doi.org/
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      Rachel E Linderman, Jenna Cava, Alison L Huckenpahler, Brittany Rego, Toco Yuen Ping Chui, Richard B Rosen, Joseph Carroll; Assessing Foveal Morphology in Individuals with Fragmented Foveal Avascular Zones. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4313. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the visual acuity and foveal morphology of individuals with microvessels disrupting the foveal avascular zone (FAZ), resulting in a “fragmented” FAZ.

Methods : Of 175 individuals with no known ocular or systemic disease, nine were found to have microvessels running through the FAZ in one eye (Figure 1). In addition, one subject with amblyopia was found to have a microvessel disrupting the FAZ in her non-amblyopic left eye, and one subject with Best disease had a microvessel disrupting the FAZ in her left eye. Seven of these individuals returned for follow-up OCT imaging in both eyes and had their monocular BCVA measured. Axial length was measured using IOL master (Carl Zeiss, Meditec) to correct for ocular magnification. Foveal pit depth, pit area, and ONL thickness (using D-OCT) were measured using Cirrus (Carl Zeiss, Meditec). Foveal inner retinal area (FIRA)1 was measured using Bioptigen (Leica Microsystems). Average avascular area and total avascular area within a 1 mm ring centered on the maximum pit depth were measured using a custom Matlab script on images acquired using the Avanti System (Optovue, Inc.).

Results : The frequency of a retinal microvessel appearing in the FAZ in our normal cohort was 5.1%. All occurrences of the aberrant vasculature were monocular. No other significant asymmetry was observed between fellow eyes including foveal pit depth, area, ONL thickness, FIRA, average avascular area, and summed avascular area (p > 0.05). All patients had at least 20/25 vision in the eye with the “fragmented” FAZ with no significant difference between eyes for visual acuity (p = 0.147, paired t-test).

Conclusions : Similar to subjects with congenital retinal macrovessels,2,3 subjects with fragmented FAZs do not have altered visual acuity or other foveal morphology.
However further studies are needed to assess if these subjects have any capillary anomalies in the brain as reported in subjects with congenital retinal macrovessels.4 Biomarkers dependent on FAZ shape (i.e. area or acircularity) or detecting intraocular asymmetry will have reduced sensitivity due to the relative commonality of “fragmented” FAZs.

1Tick PMID: 21803966
2Brown PMID:7115168
3Strampe PMID:29260109
4Pichi PMID:29494725

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Fig. 1. Example of a subject with a fragmented FAZ in the right eye.

Fig. 1. Example of a subject with a fragmented FAZ in the right eye.

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