Topographical relationship between the choroidal watershed zone and submacular idiopathic choroidal neovascularisation.
OBJECTIVE
To investigate the relationship between idiopathic choroidal neovascularisation (CNV) and choroidal watershed zones (CWZs) using indocyanine green angiography (ICGA).


METHODS
Multicentre, retrospective, interventional case series.


METHODS
The medical records and ICGA findings of 44 patients (44 eyes) diagnosed with idiopathic CNV were reviewed. CWZs, defined as hypofluorescence that disappeared during the early phase of ICGA, were classified, and the findings were compared with those of a control group of 30 eyes. The topographical relationship between CWZs and CNV was evaluated. Visual acuity and recurrence were analysed according to the CWZ classification.


RESULTS
The CNV lesion was subfoveal in 16 eyes, juxtafoveal in 12 eyes and extrafoveal in 16 eyes. The most common types of CWZs were stellate (23 eyes, 52.3%) and vertical (19 eyes, 43.2%). CWZs involving the fovea were seen in more patients with idiopathic CNV (37 eyes, 84.1%) than in the control group (11 eyes, 36.7%, p<0.001). The topographical relationship between CWZs and CNV was determined in 42 eyes (95.5%), with the CNV located within the CWZ in 39 eyes and at the margin in 3 eyes. Extrafoveal CNV was within the CWZ in all 16 affected eyes. At 6 months, visual acuity was significantly worse in patients with subfoveal CNV (p=0.028) or stellate CWZs (p=0.039).


CONCLUSIONS
The findings of a CWZ were related to the location and functional outcome of idiopathic CNV. Our results suggest that choroidal circulation is a predisposing factor for the development of CNV in young patients.
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Ji Eun
JE
Lee
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Min Kyu
MK
Shin
Department of Ophthalmology, Gyeongsang National University, JinJu, Republic of Korea.
In Young
IY
Chung
Department of Ophthalmology, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.
Joo Eun
JE
Lee
Department of Ophthalmology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.
Hyun Woong
HW
Kim
Department of Ophthalmology, Gospel hospital, College of Medicine, Kosin University, Busan, Republic of Korea Institute for medicine, Kosin University, Busan, Republic of Korea.
Sang Joon
SJ
Lee
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Sung Who
SW
Park
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Ik Soo
IS
Byon
D000293:Adolescent; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D002196:Capillaries / Q000502:physiology; D002829:Choroid / Q000098:blood supply*; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004396:Coloring Agents / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D000069579:Ranibizumab / Q000627:therapeutic use; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D020533:Angiogenesis Inhibitors; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D007208:Indocyanine Green; D000069579:Ranibizumab
Choroid; Imaging; Neovascularisation