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Photoreceptor damage in pachychoroid pigment epitheliopathy

Eye volume 39, pages 2774–2779 (2025)Cite this article

Subjects

Abstract

Purpose

To investigate the relationship between choriocapillaris perfusion and photoreceptor integrity in pachychoroid pigment epitheliopathy (PPE).

Methods

We compared 44 PPE eyes with 30 healthy controls using swept-source OCT angiography to analyse ellipsoid zone reflectivity, choriocapillaris flow deficit percentage (FD%) and retinal capillary perfusion.

Results

PPE eyes showed significantly reduced EZ reflectivity compared to controls (0.73 ± 0.10 vs 0.79 ± 0.05, p = 0.014), increased choriocapillaris ischemia (CC FD%: 46.6 ± 6.3 vs 32.5 ± 2.9, p < 0.001), and reduced deep capillary plexus perfusion (33.1 ± 4.6 vs 38.6 ± 3.3, p < 0.001). Multiple regression analysis revealed a significant inverse association between increased CC ischemia and reduced EZ reflectivity (r = −0.364, p < 0.001).

Conclusion

Choriocapillaris ischemia significantly correlates with photoreceptor damage in PPE, suggesting vascular dysfunction as a key pathogenic mechanism.

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Fig. 1: Methodology for quantitative analysis of ellipsoid zone (EZ) reflectivity.
Fig. 2: Representative optical coherence tomography angiography (OCTA) images showing the vascular analysis process.
Fig. 3: Comparison of ellipsoid zone (EZ) and choriocapillaris (CC) characteristics between control and pachychoroid pigment epitheliopathy (PPE) groups.

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Data availability

The datasets generated and analysed during the current study are not publicly available due to privacy concerns and regulations regarding patient data protection, but de-identified data are available from the corresponding author upon reasonable request and with appropriate institutional review board approval.

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Funding

PV is a consultant for: Abbvie, Bayer, Hofmann La Roche, Novartis and Zeiss. FB is a consultant for: Alcon, Abbvie, Bayer, Hofmann La Roche, Novartis and Zeiss. Other authors: None.

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Authors and Affiliations

  1. Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, Bari, Italy

    Pasquale Viggiano, Alba Chiara Termite, Giacomo Boscia, Maria Grazia Pignataro, Mariapia Laterza, Arcangelo Clemente, Giovanni Alessio & Francesco Boscia

  2. Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy

    Stefano Dore

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  1. Pasquale Viggiano
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Contributions

PV conceived the study, performed data analysis and drafted the manuscript. GB and AC contributed to study design and critically revised the manuscript. ML and ACT were involved in data collection and interpretation. MGP and AC provided expertise in image analysis and contributed to the interpretation of results. SD and GA contributed to patient recruitment and data collection. FB and GA provided statistical expertise and critical feedback. FB supervised the study, provided critical feedback and helped shape the research and analysis. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Pasquale Viggiano.

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Viggiano, P., Termite, A.C., Boscia, G. et al. Photoreceptor damage in pachychoroid pigment epitheliopathy. Eye 39, 2774–2779 (2025). https://doi.org/10.1038/s41433-025-03947-3

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