Remodeling of macular vortex veins in pachychoroid neovasculopathy

• Published in: Scientific reports Vol. 9; no. 1; pp. 14689 - 7
• Main Authors: Matsumoto, Hidetaka, Kishi, Shoji, Mukai, Ryo, Akiyama, Hideo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11.10.2019; Nature Publishing Group
• Subjects: 692/308/53/2421; 692/699/3161/1626; Aged; Anastomosis; Choroid; Choroidal Neovascularization - diagnostic imaging; Dilatation, Pathologic - diagnostic imaging; Female; Humanities and Social Sciences; Humans; Macula Lutea - blood supply; Male; Middle Aged; multidisciplinary; Retinal Vein - diagnostic imaging; Retrospective Studies; Science; Science (multidisciplinary); Tomography, Optical Coherence - methods; Vascular Fistula - diagnostic imaging; Vascular Remodeling; Veins & arteries; Visual Acuity; Watersheds
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-51268-9

Superior and inferior macular vortex veins are divided by a horizontal watershed passing through the macula. We evaluated macular vortex vein remodeling in eyes with pachychoroid neovasculopathy (PNV). Thirty eyes of 30 patients with treatment-naïve PNV and 30 normal eyes of 30 age-, gender-, and refraction-matched subjects were studied. We assessed the features of macular vortex veins employing en face optical coherence tomography (OCT) and determined central choroidal thickness (CCT) using B-mode OCT. Of the 30 normal eyes, a horizontal watershed was identified in 24 eyes (80%), while venous anastomosis between the superior and inferior vortex veins was observed in 6 eyes (20%). Mean CCT was 233 μm. Of the 30 eyes with PNV, vortex veins were dilated in all 30 eyes with PNV. In 27 of the 30 PNV eyes (90%), the horizontal watershed had disappeared, and collateral veins had instead developed via anastomosis between the superior and inferior vortex veins, making this finding significantly more frequent than in normal eyes ( P  < 0.001). Mean CCT was 357 μm, significantly thicker than that of normal eyes ( P  < 0.001). Remodeling of choroidal drainage routes by venous anastomosis between superior and inferior vortex veins was common in eyes with PNV. This observation suggests longstanding congestion of the choroidal veins.