title: ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY FEATURES IN AREAS OF CHORIOCAPILLARIS HYPOPERFUSION.
abstract: OBJECTIVE
  To detect choriocapillaris changes by enhanced depth imaging optical coherence tomography (EDI-OCT) in areas of choriocapillaris hypoperfusion visualized on indocyanine green angiography.
  
  
  METHODS
  Combined indocyanine green angiography and EDI-OCT from patients diagnosed with inflammatory choriocapillaris hypoperfusion were retrospectively analyzed. The EDI-OCTs were compared with indocyanine green angiography to detect choriocapillaris changes suggestive of choriocapillaris hypoperfusion in both active stage (AS) and inactive stage of the disease. The EDI-OCT was graded by two independent observers for choriocapillaris pattern (normal/altered) and reflectivity (hyper/hypo/isoreflective) changes. Manual measurements of choriocapillaris thickness were obtained. Interobserver agreement was assessed using Cohen's kappa, and differences in groups were assessed using McNemar's test.
  
  
  RESULTS
  Forty-two lesions from 11 eyes (8 patients, 3 males) were analyzed. Three patients (4 eyes, 17 lesions) were diagnosed with serpiginous choroiditis, and 5 patients (7 eyes, 25 lesions) were diagnosed with acute posterior multifocal placoid pigmented epitheliopathy. All the lesions demonstrated choriocapillaris hyporeflectivity on EDI-OCT during AS and isoreflectivity during inactive stage. The characteristic choriocapillaris dotted pattern was absent during AS. Choriocapillaris thickness at the sites of hypoperfusion was significantly higher during AS (63.07 ± 16.47 μm) than in inactive stage (22.92 ± 7.65 μm) (P < 0.001). Disruption of retinal pigment epithelium during AS was strongly associated with choriocapillaris atrophy during follow-up (P < 0.001).
  
  
  CONCLUSIONS
  The EDI-OCT shows characteristic choriocapillaris changes suggestive of choriocapillaris hypoperfusion that correlate with ischemia on indocyanine green angiography during both AS and inactive stage of the disease.
authors.affiliation: *Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy; †Ophthalmological Unit, Department of Clinical Sciences and Community Health, IRCCS-Cà Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; and ‡Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Invernizzi
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Agarwal
authors.forename: Mariano
authors.initials: M
authors.lastname: Cozzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
authors.forename: Quan Dong
authors.initials: QD
authors.lastname: Nguyen
authors.forename: Giovanni
authors.initials: G
authors.lastname: Staurenghi
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D002196:Capillaries / Q000503:physiopathology; D002829:Choroid / Q000098:blood supply* / Q000000981:diagnostic imaging; D015862:Choroid Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004396:Coloring Agents / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D055213:Retinal Pigment Epithelium / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green