title: Choroidal Round Hyporeflectivities in Geographic Atrophy.
abstract: OBJECTIVE
  In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A).
  
  
  METHODS
  Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed.
  
  
  RESULTS
  Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01).
  
  
  CONCLUSIONS
  Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Corbelli
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.|Department of Ophthalmology, University of Verona, University hospital of Verona, Verona, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sacconi
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Luigi Antonio
authors.initials: LA
authors.lastname: De Vitis
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.|Department of Ophthalmology, University of "Magna Graecia", Catanzaro, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Carnevali
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rabiolo
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Lea
authors.initials: L
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
authors.affiliation: Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D057092:Geographic Atrophy / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D041623:Tomography, Optical Coherence