![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
ABSTRACT
Background
The choroidal vasculature supplies the outer retina and is altered in many retinal diseases, including myopic traction maculopathy (MTM). Choroid health is typically assessed by measuring the choroidal thickness; however, this method has substantial limitations. The choroidal vascularity index (CVI) was recently introduced to provide quantitative information on the vascular flow in the choroid. This index has been evaluated in a wide range of diseases but has not been extensively used to characterize MTM.
Aim
This study aimed to investigate the CVI across different stages of MTM and the influence of macular surgery on choroidal perfusion markers in different surgically resolved MTM stages.
Methods
Eighteen healthy myopic eyes in the control group and forty-six MTM eyes in the surgical group were evaluated using enhanced optical coherence tomography (OCT) imaging. Binarized OCT images were processed to obtain the luminal choroidal area (LCA) and stromal choroidal area (SCA), which were used to calculate CVI in the form of a percentage ratio. CVI data were collected at baseline, one and four months postoperatively, and at the final clinical visit. MTM eyes were divided into four stages based on disease severity. The choriocapillaris flow area (CFA) and central subfield thickness (CSFT) were measured along side the CVI.
Results
No significant differences were observed between the two groups at baseline, except for visual acuity (p < 0.0001). Surgery significantly improved vision at all postoperative time points (p < 0.0001). At baseline, there were no significant differences in CVI, CFA, or CSFT scores between the control and surgical groups. However, all three measurements were lower at the final visit in the surgical group (p ≤0.0001). No significant differences were found in any of the parameters among the four stages of MTM (p > 0.05). Ultimately, correlation and multivariate linear regression analyses did not reveal any significant association between CVI and visual acuity.
Conclusions
This study did not find significant preoperative differences in CVI between healthy myopic eyes and eyes with MTM. However, the postoperative CVI and CFA values were significantly lower than those of the control eyes. Thus, CVI may not be a good biomarker for surgical outcomes, as the correlation between CVI and visual acuity was not statistically significant.The CVI and CFA decreased after surgery, providing evidence of choroidal changes after surgical management.
ABBREVIATIONS
| ATN | = | atrophic (A), tractional (T), and neovascular (N) |
| BCVA | = | best-corrected visual acuity |
| CFA | = | choriocapillaris foveal area |
| CFT | = | central foveal thickness |
| CSP | = | choriocapillaris subfoveal plexus |
| CSFT | = | central subfield thickness |
| CVI | = | choroidal vascularity index |
| ERM | = | epiretinal membrane |
| FS-ILM | = | foveal sparing ILM peeling technique |
| FRD | = | foveoretinal detachment |
| ILM | = | internal limiting membrane |
| LCA | = | luminal choroidal area |
| LogMAR | = | logarithm of the minimum angle of resolution |
| FS | = | foveoschisis |
| MH | = | macular hole |
| MHRD | = | macular hole retinal detachment |
| MTM | = | myopic traction maculopathy |
| OCT | = | optical coherence tomography |
| OCT | = | A optical coherence tomography angiography |
| PPV | = | pars plana vitrectomy |
| PM | = | pathologic myopia |
| PS | = | posterior staphyloma |
| PVR | = | proliferative vitreoretinopathy |
| RPE | = | retinal pigment epithelium |
| RRD | = | rhegmatogenous retinal detachment |
| RD | = | retinal detachment |
| SD-OCT | = | spectral-domain OCT |
| SCA | = | stromal choroidal area |
| SRF | = | subretinal fluid |
| TCA | = | total choroidal area |
ACKNOWLEDGMENTS
We express our deep appreciation to the technical staff of the Retina Department of Oftalmologia Integral ABC (a Medical and Surgical Nonprofit Organization), Mexico City, Mexico, which is affiliated with The Postgraduate Division Studies at the National Autonomous University of Mexico.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
DATA AVAILABILITY STATEMENT
The datasets used in this study have been included in the main text. Photographs and figures from this study may be released via a written application to the Photographic Laboratory and Clinical Archives Retina Department at the Oftalmologia Integral ABC, Medical and Surgical Assistance Institution (Nonprofit Organization), Av. Paseo de las Palmas 735 suite 303, Lomas de Chapultepec, Mexico City 11,000, Mexico and the corresponding author upon request. The data analysis can be found in the supplementary file.
ETHICS APPROVAL AND CONSENT TO PARTICIPATE
This study adhered to the tenets of the Declaration of Helsinki and received full approval from the appropriate research ethics committee, institutional review committee, and institutional teaching department (the institutions did not provide reference numbers for the retrospective studies).
AUTHOR CONTRIBUTIONS
MAQR, study conception, writing the manuscript, dataset interpretation, statistical analysis interpretation, final revision, conclusions; EAQG, figure artwork, tables, material compilation; MAQG, figure and table construction; VLG, statistical analysis and final revision. All the authors have approved the manuscript for submission.
INSTITUTIONAL REVIEW BOARD STATEMENT
This study was conducted at the Retina Department of the Oftalmologia Integral ABC Institution in Mexico City. The institutional review board approved the study according to the institutional guidelines. No reference number was provided for the retrospective studies at this institution.