June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Analysis of Choriocapillaris Flow Deficits Before and After Tears of the Retinal Pigment Epithelium using Swept Source OCT Angiography
Author Affiliations & Notes
  • Prashanth Iyer
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • yingying shi
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Zhongdi Chu
    University of Washington, Seattle, Washington, United States
  • Omer Trivizki
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Mengxi Shen
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Ruikang K Wang
    University of Washington, Seattle, Washington, United States
  • William J Feuer
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Giovanni Gregori
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Philip J Rosenfeld
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Prashanth Iyer, None; yingying shi, None; Zhongdi Chu, None; Omer Trivizki, None; Mengxi Shen, None; Ruikang Wang, Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Carl Zeiss Meditec (P); William Feuer, None; Giovanni Gregori, Carl Zeiss Meditec (F), Carl Zeiss Meditec (P); Philip Rosenfeld, Carl Zeiss Meditec (F), Carl Zeiss Meditec (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2495. doi:
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      Prashanth Iyer, yingying shi, Zhongdi Chu, Omer Trivizki, Mengxi Shen, Ruikang K Wang, William J Feuer, Giovanni Gregori, Philip J Rosenfeld; Analysis of Choriocapillaris Flow Deficits Before and After Tears of the Retinal Pigment Epithelium using Swept Source OCT Angiography. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2495.

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

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Abstract

Purpose : Tears of the retinal pigment epithelium (RPE) occur in age-related macular degeneration (AMD) as part of normal disease progression or after injections with anti-VEGF. This provides opportunity to investigate two questions: does the presence of an intact pigmented RPE interfere with our ability to measure choriocapillaris (CC) flow deficits (FDs) and is the survival of the CC dependent on an intact overlying RPE. To answer these questions, we compared our CC FD measurements before and after a RPE tear and followed the change in CC FDs over time once the overlying RPE was removed.

Methods : Patients with AMD who developed RPE tears were enrolled in a prospective, swept source OCT (SS-OCT) imaging study and 6x6 mm scans centered on the fovea were acquired (PLEXÒ Elite 9000, Carl Zeiss Meditec, Dublin, CA). Scans were obtained before and after the RPE tear formation, and during follow-up visits. CC FDs were measured at the site of the tear and within a control region symmetrically positioned to the fovea.

Results : Three AMD patients were followed before and after the RPE tear developed for 18 months. Two patients had a history of type 1 macular neovascularization and anti-VEGF therapy, and one patient had non-neovascular AMD. All three had macular CC FD that were previously determined to be within the 95% normal limits for age-adjusted eyes. When CC FD before the RPE tear were compared with those at the first post-tear visit, the average CC FD percentage decreased -0.7% in region of tear and -1.0% in control region (p=0.92, paired t-test). When CC FD from the first post-RPE tear visit were compared to 18-month follow-up visit, the average CC FD percentage decreased -1.9% in region of tear and increased +2.0% in control region (p=0.31, paired t-test).

Conclusions : SS-OCTA imaging of eyes with RPE tears indicate that there were no significant changes in CC FD before and after the RPE tears. Although the sample size was small, it appears that our CC algorithm for measuring FDs is reliable demonstrated by consistent measurements before and after the RPE was removed. Furthermore, removal of the RPE did not lead to significant changes in the CC over 18 months. This differs from animal studies demonstrating that RPE removal resulted in rapid loss of CC. The relationship between CC and RPE may not be absolute as previously believed.

This is a 2021 ARVO Annual Meeting abstract.

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